데스메막박리 각막내피층판이식술 후 이식편 실패가 온 환자에서의 데스메막내피각막이식술
Descemet Membrane Endothelial Keratoplasty to Treat Graft Failure after Descemet Stripping Endothelial Keratoplasty
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목적: 데스메막박리 각막내피층판이식술(Descemet stripping endothelial keratoplasty, DSEK) 후 이식편 실패가 온 환자에 2차적 데스메막내피각막이식(Descemet membrane endothelial keratoplasty, DMEK)을 성공적으로 시행하여 이를 보고하고자 한다. 증례요약: 66세 여자 환자가 6년 전 우안에 백내장수술을 받고, 한 차례 인공수정체교환술을 받은 뒤 수포각막병증이 발생하여 데스메막박리 각막내피층판이식술을 시행받았다. 5년간 시력을 잘 유지해오다가, 이식편 실패로 인해 시력이 감소하게 되었다. 해당 환자는 데스메막박리 각막내피층판이식술 후 녹내장이 발병하였던 상태로, 2차 각막이식술은 데스메막내피각막이식술로 시행하였으며 추가적인 공기주입 없이 수술은 성공하였다. 수술 3개월 후 교정시력은 0.2였으며 각막은 투명하였다. 결론: 데스메막박리 자동각막내피층판이식술 후 이식편 실패가 온 환자에서 2차적으로 데스메막내피각막이식술을 성공적으로 시행하였으며 수술 후 5개월까지 각막이식편의 실패 없이 투명한 각막을 유지하였다.
Abstract
Purpose: We report a case of secondary Descemet membrane endothelial keratoplasty (DMEK) to treat graft failure after Descemet stripping endothelial keratoplasty (DSEK). Case summary: A 66-year-old female underwent DSEK of her right eye to treat pseudophakic bullous keratopathy that developed after cataract surgery and intraocular lens exchange. After 5 years, she complained of decreased vision; graft failure was observed. Secondary DMEK was performed; no additional air injection was needed. The corrected visual acuity was 0.2, 3 months after surgery, and the cornea became clear. Conclusions: Visual recovery can be achieved by performing secondary DMEK after primary DSEK graft failure.
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