J Korean Ophthalmol Soc > Volume 56(5); 2015 > Article
Journal of the Korean Ophthalmological Society 2015;56(5):664-671.
DOI: https://doi.org/10.3341/jkos.2015.56.5.664    Published online May 15, 2015.
Clinical Outcomes of Nd-YAG Laser Membranotomy in Retained Host Corneal Membrane after Keratoplasty.
Yong Chan Kim, Jae Hyung Hwang, Man Soo Kim
1Department of Ophthalmology, The Catholic University of Korea College of Medicine, Seoul, Korea. mskim@catholic.ac.kr
2Department of Ophthalmology, Inje University College of Medicine, Busan, Korea.
각막이식 후 발생한 수여 잔류막에 대한 야그레이저 치료 효과
가톨릭대학교 의과대학 안과학교실1, 인제대학교 의과대학 안과학교실2
To evaluate the clinical efficacy and shortcomings of neodymium-doped yttrium aluminum garnet (Nd-YAG) laser membranotomy in inadvertently retained host membrane. METHODS: Among 742 patients who underwent penetrating keratoplasty (PKP) and deep anterior lamellar keratoplasty (DALK) surgery at Seoul St. Mary's Hospital between January 2007 and May 2013 by a single surgeon, 10 patients had a thin, opaque membrane in the anterior chamber observed under slit lamp examination and both a subjective decrease in visual acuity and decrease i best corrected visual acuity. A single surgeon performed membranotomy using the Nd-YAG laser at 4.9 months after graft surgery. In this study we compared the differences in visual acuity, endothelial cell count and correlations between distance from donor endothelium and retained host membrane and endothelial loss before and after the graft surgery. RESULTS: Patients who had Nd-YAG laser membranotomy performed on the retained host membrane showed significant improvements in visual acuity (p = 0.039). Donor endothelial cell count was significantly reduced 1 month after Nd-YAG laser. The average distance between donor endothelium and retained host membrane was 712.0 +/- 217.5 microm. The distance and the decreased donor endothelial cell count were not statistically correlated (R2 = 0.39, p = 0.072). There were no significant complications after the laser membranotomy. CONCLUSIONS: Inadvertently retained host membrane forms close to the donor endothelium as identified on optical coherence tomography (OCT) images. Nd-YAG laser membranotomy significantly affected clear vision but endothelial cell count loss was also observed.
Key Words: DALK surgery;Endothelial cell count;Nd-YAG laser;PKP surgery;Retained host membrane

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