角膜后弹力层脱离的诊疗方法及其研究进展

Development in the diagnosis and treatment of Descemet′s membrane detachment

角膜后弹力层脱离是内眼手术的并发症之一,尤其在白内障摘除手术中较为常见。此并发症通常在术中出现,根据临床表现正确判断并处理,预后较好,但诊断和处理不及时后果严重,应引起临床重视。本文针对角膜后弹力层脱离的危险因素、临床表现、治疗和预后,总结并分析相关研究进展,以期为临床提高相关诊疗水平提供参考。

Descemet′s membrane detachment(DMD)is a complication of intraocular surgery and is more likely to be seen after cataract surgery.As an intraoperative event,DMD usually features wrinkles and edema on the posterior corneal surface or floating membranoid substance seen in the anterior chamber.Such edema is often seen as surgery-caused corneal edema and membranoid substance as the anterior capsule of the lens.Thus,DMD is easily clinically ignored,even though it is conveniently treated if timely observed.Serious consequences are not uncommon with any delayed diagnosis or treatment.Risk factors include advanced age,previous corneal endothelial lesions and glaucoma,as well as preoperative shallow anterior chamber.Clinical diagnosis is based upon intraoperative judgment,corneal edema diagnosed under a microscope or slit lamp and consequent floating Descemet′s membrane.In serious cases,anterior segment OCT and UBM are required.Intracameral injections of air are traditionally adopted in the treatment.In less serious cases,patients see self-healing.