Retinal cases & brief reports · 2023
DESCEMET STRIPPING AUTOMATED ENDOTHELIAL KERATOPLASTY GRAFT IN-THE-BAG POSTERIOR DISLOCATION.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Levine Harry, Gibbons Allister, Martinez Jaime D, Smiddy William E
Аннотация
PURPOSE: The purpose of this report was to describe a case of a dislocated Descemet stripping automated endothelial keratoplasty graft retained in-the-bag removed with pars plana vitrectomy (PPV).
METHODS: This was a case report.
RESULTS: A 69-year-old pseudophakic man who underwent a repeat Descemet stripping automated endothelial keratoplasty due to bullous keratopathy in the setting of multiple previous ocular surgeries presented with a vision of counting fingers. On examination, a Descemet stripping automated endothelial keratoplasty graft was appreciated behind the intraocular lens obscuring the visual axis and presumed to be in the anterior vitreous. The patient underwent a 23-gauge vitrectomy, and after a posterior capsulotomy, the dislocated graft was removed with a 23-gauge vitrector without complications. The best-corrected visual acuity was 20/50 6 months after the PPV. Grafts can dislocate posteriorly between the intraocular lens and the posterior capsule. The dislocated graft can be successfully extricated with a 23-gauge vitrector after a careful posterior capsulotomy, with good visual outcomes.
IMPORTANCE: To the best of our knowledge, this is the first reported case of an in-the-bag Descemet stripping automated endothelial keratoplasty graft posterior dislocation. Furthermore, we showed an innovative surgical technique for the removal of the dislocated graft with a 23-gauge vitrectomy and posterior capsulotomy.
METHODS: This was a case report.
RESULTS: A 69-year-old pseudophakic man who underwent a repeat Descemet stripping automated endothelial keratoplasty due to bullous keratopathy in the setting of multiple previous ocular surgeries presented with a vision of counting fingers. On examination, a Descemet stripping automated endothelial keratoplasty graft was appreciated behind the intraocular lens obscuring the visual axis and presumed to be in the anterior vitreous. The patient underwent a 23-gauge vitrectomy, and after a posterior capsulotomy, the dislocated graft was removed with a 23-gauge vitrector without complications. The best-corrected visual acuity was 20/50 6 months after the PPV. Grafts can dislocate posteriorly between the intraocular lens and the posterior capsule. The dislocated graft can be successfully extricated with a 23-gauge vitrector after a careful posterior capsulotomy, with good visual outcomes.
IMPORTANCE: To the best of our knowledge, this is the first reported case of an in-the-bag Descemet stripping automated endothelial keratoplasty graft posterior dislocation. Furthermore, we showed an innovative surgical technique for the removal of the dislocated graft with a 23-gauge vitrectomy and posterior capsulotomy.