Maximilian K Köppe, Ramin Khoramnia, Gerd U Auffarth, Victor A Augustin
{"title":"利用高分辨率扫描源 OCT 成像,观察由 Descemet 膜脱落引起的假性角膜水肿。","authors":"Maximilian K Köppe, Ramin Khoramnia, Gerd U Auffarth, Victor A Augustin","doi":"10.3205/oc000244","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Small Descemet membrane detachments after cataract surgery are relatively common and most cases do not require any secondary surgical intervention and can be treated conservatively. However, in case of advanced Descemet membrane detachment (DMD), it needs to be recognized and treated appropriately. The advent of anterior segment imaging using optical coherence tomography (OCT) technology has made diagnosing pathologies of the anterior segment accurate and time efficient and has proven as an invaluable tool to guide decision making.</p><p><strong>Case presentation: </strong>A 71-year-old patient presented after complicated cataract surgery with decreased visual acuity and cloudy vision. On examination, best corrected visual acuity was 1.5 logMAR. A high-resolution swept-source OCT (Anterion, Heidelberg Engineering, Heidelberg, Germany) was used to better evaluate and visualize the extent of DMD. An anterior chamber gas bubble was injected to reattach the Descemet membrane (DM) to the corneal stroma. The success of the surgery was visualized using the high-resolution swept-source OCT. This revealed a completely attached Descemet membrane.</p><p><strong>Conclusions: </strong>Clinically, it can be difficult to distinguish the etiology of epithelial and stromal edema post cataract surgery. This case demonstrated the clinical usefulness using high resolution swept source imaging to guide clinical decision making in evaluating timing and treatment success of pneumodescemetopexy after complicated cataract surgery.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"14 ","pages":"Doc12"},"PeriodicalIF":0.0000,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462704/pdf/","citationCount":"0","resultStr":"{\"title\":\"Pseudophakic corneal edema caused by Descemet membrane detachment using high-resolution swept-source OCT imaging.\",\"authors\":\"Maximilian K Köppe, Ramin Khoramnia, Gerd U Auffarth, Victor A Augustin\",\"doi\":\"10.3205/oc000244\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Small Descemet membrane detachments after cataract surgery are relatively common and most cases do not require any secondary surgical intervention and can be treated conservatively. However, in case of advanced Descemet membrane detachment (DMD), it needs to be recognized and treated appropriately. The advent of anterior segment imaging using optical coherence tomography (OCT) technology has made diagnosing pathologies of the anterior segment accurate and time efficient and has proven as an invaluable tool to guide decision making.</p><p><strong>Case presentation: </strong>A 71-year-old patient presented after complicated cataract surgery with decreased visual acuity and cloudy vision. On examination, best corrected visual acuity was 1.5 logMAR. A high-resolution swept-source OCT (Anterion, Heidelberg Engineering, Heidelberg, Germany) was used to better evaluate and visualize the extent of DMD. An anterior chamber gas bubble was injected to reattach the Descemet membrane (DM) to the corneal stroma. The success of the surgery was visualized using the high-resolution swept-source OCT. This revealed a completely attached Descemet membrane.</p><p><strong>Conclusions: </strong>Clinically, it can be difficult to distinguish the etiology of epithelial and stromal edema post cataract surgery. This case demonstrated the clinical usefulness using high resolution swept source imaging to guide clinical decision making in evaluating timing and treatment success of pneumodescemetopexy after complicated cataract surgery.</p>\",\"PeriodicalId\":73178,\"journal\":{\"name\":\"GMS ophthalmology cases\",\"volume\":\"14 \",\"pages\":\"Doc12\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-09-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462704/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"GMS ophthalmology cases\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3205/oc000244\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"GMS ophthalmology cases","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3205/oc000244","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
背景:白内障手术后出现小的去角膜脱离比较常见,大多数病例不需要二次手术干预,可以采取保守治疗。但是,如果是晚期的去角膜脱离(DMD),则需要识别并进行适当的治疗。利用光学相干断层扫描(OCT)技术进行眼前节成像的出现,使眼前节病变的诊断变得准确、省时,并被证明是指导决策的宝贵工具:一位 71 岁的患者在复杂的白内障手术后出现视力下降和视物混浊。经检查,最佳矫正视力为 1.5 logMAR。为了更好地评估和观察 DMD 的范围,我们使用了高分辨率扫源 OCT(Anterion,海德堡工程公司,德国海德堡)。手术中注入了前房气泡,以使德斯梅尔膜(DM)与角膜基质重新连接。手术成功与否可通过高分辨率扫描源 OCT 观察。结论:在临床上,白内障手术后上皮和基质水肿的病因很难区分。该病例表明,使用高分辨率扫源成像技术指导临床决策,对复杂白内障手术后的积气囊成形术的时机和治疗成功与否进行评估是非常有用的。
Pseudophakic corneal edema caused by Descemet membrane detachment using high-resolution swept-source OCT imaging.
Background: Small Descemet membrane detachments after cataract surgery are relatively common and most cases do not require any secondary surgical intervention and can be treated conservatively. However, in case of advanced Descemet membrane detachment (DMD), it needs to be recognized and treated appropriately. The advent of anterior segment imaging using optical coherence tomography (OCT) technology has made diagnosing pathologies of the anterior segment accurate and time efficient and has proven as an invaluable tool to guide decision making.
Case presentation: A 71-year-old patient presented after complicated cataract surgery with decreased visual acuity and cloudy vision. On examination, best corrected visual acuity was 1.5 logMAR. A high-resolution swept-source OCT (Anterion, Heidelberg Engineering, Heidelberg, Germany) was used to better evaluate and visualize the extent of DMD. An anterior chamber gas bubble was injected to reattach the Descemet membrane (DM) to the corneal stroma. The success of the surgery was visualized using the high-resolution swept-source OCT. This revealed a completely attached Descemet membrane.
Conclusions: Clinically, it can be difficult to distinguish the etiology of epithelial and stromal edema post cataract surgery. This case demonstrated the clinical usefulness using high resolution swept source imaging to guide clinical decision making in evaluating timing and treatment success of pneumodescemetopexy after complicated cataract surgery.