白内障超声乳化术后显性及隐匿性角膜后弹力膜脱离的临床分析及处理

Analysis and treatment of explicit and occult Descemet's membrane detachment after phacoemulsification

摘要:

目的： 分析白内障超声乳化术后显性及隐匿性角膜后弹力膜脱离的原因，并提出治疗措施。

方法： 对我院2013-01/2016-04临床发现的31例31眼显性及隐匿性角膜后弹力膜脱离患者经过1～3次前房注射消毒空气治疗，术后随访3mo，观察角膜恢复情况。

结果： 所有患者中，30例30眼角膜均恢复透明，未出现视力功能障碍及其他相关并发症，效果满意。1例1眼因不配合治疗发生大疱性角膜炎。

结论： 白内障超声乳化术后显性及隐匿性角膜后弹力膜脱离的原因有内部及外部诸多因素。及早发现和及时处理，对角膜后弹力膜脱离患者的视力恢复有重要意义。对术后难治性角膜水肿患者及早行前节OCT或UBM检查，有助于发现不同程度隐匿性角膜后弹力膜脱离，并制定针对性治疗方案。

Abstract:

AIM: The reasons of explicit and occult Descemet's membrane detachment(DMD)after phacoemulsification were analyzed and the therapeutic measures were further provided.

METHODS:A total of 31 cases diagnosed as explicit and occult DMD between Jan. 2013 and Apr. 2016 received the injection of sterile air into anterior chamber by 1-3 times, and were followed up for 3mo to observe the recoveries of cornea.

RESULTS: A total of 30 cases recovered with no visual impairment and other related complications.One case which refused being treated resulted in bullous keratitis.

CONCLUSION:Both the internal and external factors can influence the operation effect of explicit and occult DMD after phacoemulsification. Early detection and timely treatment play important roles in improving patients' visual acuity. Early examination of anterior segment OCT or UBM for intractable corneal edema is helpful to find the occult DMD with different degree and work out the targeted therapies.