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Modified deep anterior lamellar dissection for corneal opacity during vitrectomy: case reports
Fang Li1,2, Leilei Zhang1,2, Yixiong Zhou1,2
1Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011, China.
BMC Ophthalmology
|August 5, 2020
Summary
This modified deep anterior lamellar dissection technique improves surgical visibility for vitreoretinal diseases with corneal opacity. It offers a less invasive alternative to traditional corneal grafts, preserving the patient's own cornea.
Area of Science:
- Ophthalmology
- Surgical Techniques
- Corneal Surgery
Background:
- Coexisting corneal opacity presents challenges in vitreoretinal surgery.
- Traditional methods like penetrating keratoplasty may be unsuitable or complex.
Observation:
- A modified deep anterior lamellar dissection technique was applied to two patients undergoing vitrectomy for retinal detachment with corneal opacity.
- Techniques included creating a corneal flap, using retroillumination for stromal removal, and employing air bubbles for endothelial decompensation.
Findings:
- The modified technique provided adequate fundus visualization for vitrectomy.
- It minimized corneal tissue removal and surgical complications.
- Postoperative outcomes included vision improvement in one case and stable endothelial decompensation in another, with successful retinal reattachment in both.
Implications:
- This modified lamellar dissection is a viable alternative to penetrating keratoplasty, ophthalmic endoscopes, and temporary keratoprostheses.
- It offers a less invasive approach for managing coexisting corneal opacity during vitreoretinal surgery.
