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Sequestered viscoelastic after deep lamellar keratoplasty using viscodissection.
Rajan D Bhojwani1, Bruce Noble, Aruna K Chakrabarty
1General Infirmary at Leeds, Leeds, West Yorkshire, United Kingdom. bbhojwani@hotmail.com
Cornea
|June 7, 2003
Summary
Deep lamellar keratoplasty (DLKP) using viscodelamination can cause a rare complication where the corneal stroma is damaged. This may necessitate a full thickness regraft, highlighting the need for careful technique during DLKP.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Surgical Complications
Background:
- Deep lamellar keratoplasty (DLKP) preserves host endothelium, avoiding rejection risks associated with penetrating keratoplasty.
- Viscodelamination is a technique used in DLKP to separate corneal stroma from Descemet's membrane with viscoelastic agents.
Observation:
- An unrecognized operative complication during viscodelamination caused significant patient morbidity.
- The complication eventually required the patient's eye to undergo a full thickness regraft.
Findings:
- Histological examination revealed the nature of the corneal stroma and its relationship with Descemet's membrane post-viscoelastic delamination.
- The study reproduced the lesion in nonviable cadaver corneas to understand the complication's mechanism.
Implications:
- This case highlights a potential, serious complication of viscodelamination in DLKP.
- Understanding this complication is crucial for refining DLKP techniques and improving patient outcomes.
- Further research may be needed to elucidate the precise mechanisms leading to this stromal damage.