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Use of viscoelastic substance for preventing Descemet's membrane rupture in deep anterior lamellar keratoplasty / Uso de substância viscoelástica na prevenção da ruptura da membrana de Descemet na ceratoplastia lamelar anterior profunda
Koçluk, Yusuf; Kasimm, Burcu; Sukgen, Emine Alyamaç.
  • Koçluk, Yusuf; Adana City Training and Research Hospital. Department of Ophthalmology. Adana. TR
  • Kasimm, Burcu; Adana City Training and Research Hospital. Department of Ophthalmology. Adana. TR
  • Sukgen, Emine Alyamaç; Adana City Training and Research Hospital. Department of Ophthalmology. Adana. TR
Arq. bras. oftalmol ; 84(3): 230-234, May-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1248960
ABSTRACT
ABSTRACT

Purpose:

This study aimed to investigate the effect of using a viscoelastic substance in Descemet's membrane rupture in "double bubble" deep anterior lamellar keratoplasty.

Methods:

The medical records and videos of surgeries of 40 patients who underwent surgery between January 2014 and July 2015 were retrospectively evaluated. The patients were divided into two groups 20 patients whose perforation of the posterior stromal wall was performed without administration of any viscoelastic substance (group 1) and 20 patients whose perforation of the posterior stromal wall was performed with administration of viscoelastic substance onto the posterior stroma (group 2). The Descemet's membrane perforation rate was compared between groups.

Results:

Perforation of the Descemet's membrane was observed in 12 (60.0%) patients in group 1 and only three (15.0%) patients in group 2. This difference was statistically significant (p=0.003). Only one (5%) patient in group 2 had macroperforation during the procedure, and the surgery was converted to penetrating keratoplasty. Eleven (55.0%) patients in group 1 had macroperforation of Descemet's membrane, and surgeries were converted to penetrating keratoplasty. This difference between the groups was statistically significant (p=0.001).

Conclusions:

Administering a viscoelastic substance onto the posterior stromal side just before puncture is an effective method to decrease the risk of Descemet's membrane perforation in deep anterior lamellar keratoplasty.(AU)
RESUMO
RESUMO

Objetivo:

Investigar o efeito do uso de uma substância viscoelástica na ruptura da membrana de Descemet em casos de ceratoplastia lamelar anterior profunda em "bolha dupla".

Métodos:

Foram avaliados retrospectivamente prontuários e vídeos de cirurgias de 40 pacientes operados entre janeiro de 2014 e julho de 2015. Os pacientes foram divididos em dois grupos 20 pacientes nos quais a parede posterior do estroma foi puncionada sem a colocação de nenhuma substância viscoelástica (grupo 1) e 20 pacientes nos quais uma substância viscoelástica foi aplicada sobre o estroma posterior ao ser puncionada a parede posterior do estroma (grupo 2). A taxa de perfuração da membrana de Descemet foi comparada entre os grupos.

Resultados:

Observou-se perfuração da membrana de Descemet em 12 casos (60,0%) no grupo 1 e em apenas 3 casos (15,0%) no grupo 2. Essa diferença foi estatisticamente significativa (p=0,003). Apenas um caso (5%) no grupo 2 teve macroperfuração durante o procedimento, sendo a cirurgia então convertida em uma ceratoplastia penetrante. Onze casos (55,0%) no grupo 1 tiveram macroperfuração da membrana de Descemet e essas cirurgias foram convertidas em ceratoplastias penetrantes. Essa diferença entre os grupos foi estatisticamente significativa (p=0,001).

Conclusões:

A aplicação de substância viscoelástica sobre o lado posterior do estroma logo antes da punção é um método eficaz para diminuir o risco de perfuração da membrana de Descemet na ceratoplastia lamelar anterior profunda.(AU)
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Corneal Transplantation / Descemet Membrane / Viscoelastic Substances Type of study: Evaluation studies Limits: Humans Language: English Journal: Arq. bras. oftalmol Journal subject: Ophthalmology Year: 2021 Type: Article Affiliation country: Turkey Institution/Affiliation country: Adana City Training and Research Hospital/TR

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Full text: Available Index: LILACS (Americas) Main subject: Corneal Transplantation / Descemet Membrane / Viscoelastic Substances Type of study: Evaluation studies Limits: Humans Language: English Journal: Arq. bras. oftalmol Journal subject: Ophthalmology Year: 2021 Type: Article Affiliation country: Turkey Institution/Affiliation country: Adana City Training and Research Hospital/TR