Descemet's stripping automated endothelium keratoplasty
- VernacularTitle:角膜后弹力层剥除自动角膜刀取材内皮移植手术的方法和体会
- Author:
Jing HONG
- Publication Type:Journal Article
- Keywords:
Descemet's stripping automated endothelium keratoplasty;
corneal disease
- From:
Ophthalmology in China
1993;0(03):-
- CountryChina
- Language:Chinese
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Abstract:
Descemet's stripping automated endothelium keratoplasty(DSAEK) has gained popularity in the surgical treatment of endothelial disorder as an alternative to penetrating keratoplasty.Selective transplantation of endothelial layer avoids the potential complications. Instead,there is structural integrity for the recipient,minimal change in refraction,and faster recovery of vision.The procedure is that:A 5 mm scleral tunnel incision was made,a special hook was used to score the descemetorhexis and strip off the recipient Descemet's membrane and endothelium,and the donor butten with part posterior stroma,Descemet membrane and endothelium was insert to anterior chamber.Filtered air then was injected to force the apposition of the posterior donor stroma to the recipient stromal bed. The surgery no suture and avoid the astigmatism post-operation.The key procedures and experiences during and post operation are that:We often meet some problem in insertion and unfold of donor button because of shallow anterior chamber in Asia.The important measure is that to reduce intraocular pressure,to avoid the anterior removal of lens-iris diaphragm and provide larger place of anterior chamber.Dislocation of donor graft is common complication,it often induce surgery failure in DSAEK.The prevent measure is that:To decrease the amount of viscoelastic and remove completely viscoelastic before insertion of donor graft.To remove the interface liquid between recipient bed and donor graft,to increase both adherence.The integrity of lens-iris diaphragm is a very important factor to maintain the stable air bubble in anterior chamber,otherwise the air bubble easily enter into vitreous cavity to loss the support the donor graft.So the indication should be caution to choice in beginning stage.
