Spontaneous Reattachment of a Detached Sutured Descemet-Stripping Automated Endothelial Keratoplasty Graft

IF 0.5 Q4 OPHTHALMOLOGY Case Reports in Ophthalmology Pub Date : 2024-01-12 DOI:10.1159/000535402

Rania E. Gad, Jonathan Kahn, Danielle Trief

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Abstract

Abstract Introduction This is a case report of a spontaneous reattachment of Descemet-stripping automated endothelial keratoplasty (DSAEK). This graft was primarily sutured, and 20% sulfur hexafluoride (SF6) was injected into the anterior chamber, followed by graft detachment and spontaneous reattachment, 3 months later. Case Presentation A 78-year-old male presented with DSAEK graft detachment, which was the patient’s second DSAEK (the first also did not adhere). During the second surgery, the DSAEK graft was sutured and 20% SF6 was injected intraoperatively. Graft reattachment occurred without any intervention or repositioning 3 months after the 2nd DSAEK surgery. Conclusion Spontaneous DSEAK late graft reattachment is possible, particularly in the setting of an anchoring suture. In some patients, waiting can be an option that can spare the patient the possible risks of graft repositioning, rebubbling, or repeating the DSAEK. Suturing the DSAEK graft primarily may have served as an anchor to keep the graft approximate and aid in attachment. A graft suture can be considered in the setting of a previously failed DSAEK due to DSAEK graft detachment.

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脱落的缝合型 Descemet-Stripping Automated Endothelial Keratoplasty 移植体的自发再粘连

摘要引言这是一例 Descemet-stripping 自动内皮角膜移植术（DSAEK）自发再粘连的病例报告。该移植物主要进行了缝合，并在前房中注射了 20% 的六氟化硫 (SF6)，3 个月后移植物脱落并自发重新附着。病例介绍一位 78 岁的男性患者因 DSAEK 移植物脱落而就诊，这是患者的第二次 DSAEK 手术（第一次手术也没有粘连）。在第二次手术中，对 DSAEK 移植物进行了缝合，并在术中注射了 20% SF6。第二次 DSAEK 手术 3 个月后，移植物重新附着，无需任何干预或重新定位。结论 DSEAK后期移植物有可能自发重新附着，尤其是在锚定缝合的情况下。对于某些患者来说，等待是一种选择，可以使患者免于移植物重新定位、重新搓揉或重复 DSAEK 的可能风险。缝合 DSAEK 移植物主要是作为锚，以保持移植物近似并帮助附着。如果之前因 DSAEK 移植物脱落导致 DSAEK 失败，则可以考虑进行移植物缝合。

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来源期刊

Case Reports in Ophthalmology OPHTHALMOLOGY-

CiteScore

0.90

自引率

0.00%

发文量

129

审稿时长

12 weeks

期刊介绍： This peer-reviewed online-only journal publishes original case reports covering the entire spectrum of ophthalmology, including prevention, diagnosis, treatment, toxicities of therapy, supportive care, quality-of-life, and survivorship issues. The submission of negative results is strongly encouraged. The journal will also accept case reports dealing with the use of novel technologies, both in the arena of diagnosis and treatment. Supplementary material is welcomed. The intent of the journal is to provide clinicians and researchers with a tool to disseminate their personal experiences to a wider public as well as to review interesting cases encountered by colleagues all over the world. Universally used terms can be searched across the entire growing collection of case reports, further facilitating the retrieval of specific information. Following the open access principle, the entire contents can be retrieved at no charge, guaranteeing easy access to this valuable source of anecdotal information at all times.