| A Case of Double Descemet's Membrane after Penetrating Keratoplasty Converted from Deep Anterior Lamellar Keratoplasty. |
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Jong Chan Im, Hong Kyun Kim, Jun Hun Lee |
1Department of Ophthalmology, Kyungpook National University School of Medicine, Daegu, Korea.
2Metro Eye Center, Daegu, Korea. eyedr.lee@gmail.com |
| 심부표층각막이식술에서 전층각막이식술로 전환한 환자에서 발생한 이중데스메막 1예 |
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임종찬1⋅김홍균1⋅이준훈2 |
Department of Ophthalmology, Kyungpook National University School of Medicine1, Daegu, Korea
Metro Eye Center2, Daegu, Korea |
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| Abstract |
PURPOSE
To report a case of double Descemet's membrane in a patient who had penetrating keratoplasty after rupture of Descemet's membrane during deep anterior lamellar keratoplasty (DALK). CASE SUMMARY: A 24-year-old female had keratoconus in her right eye and underwent DALK for treatment. Descemet's membrane was ruptured while separating the corneal stroma from Descemet's membrane with the big bubble technique. The operation method was changed from DALK to penetrating keratoplasty. Detached Descemet's membrane was observed in the anterior chamber after suturing. Sterile air was injected into the anterior chamber to attach the Descemet's membrane. Five days after the surgery, Descemet's membrane was detached and a second air injection was performed. Corneal edema was improved but Descemet's membrane was re-detached. Double Descemet's membrane was observed by anterior segment optical coherence tomography (OCT). The detached Descemet's membrane originated from the recipient's cornea and not from the donor's cornea. Detached Descemet's membrane was removed successfully. Patient's cornea was clear and best corrected visual acuity was 20/25. CONCLUSIONS: When penetrating keratoplasty is performed instead of DALK, the surgeon should completely remove the remnant corneal stroma and Descemet's membrane. Remnant Descemet's membrane can be disregarded as it comes from the donor cornea. Unnecessary anterior chamber air injection causes endothelial damage. Anterior segment OCT is a useful tool to identify anatomical structures of transplanted cornea. |
| Key Words:
Anterior segment OCT;DALK;Double Descemet's membrane;PKP |
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