Ten Cases of Recipient Opaque Endothelial Membrane Disruption by Nd:YAG Laser in Keratoplasty
Narrative Responses:
Purpose
To report ten cases of the recipient opaque endothelial membrane disruptured by Nd-YAG laser in penetrating and lamella keratoplasty.
Methods
Retention of the host’s endothelial membrane including posterior part of stroma is an unusual complication of penetrating keratoplasty. The membrane seemed clear at the first time of penetrating keratoplasty, however, as time goes by, it was gradually opacified and thickened like posterior capsular opacity after cataract surgery. The endothelial membrane detected by using AS-OCT and slit Biomicroscopy was located about more than 500~1000mm away from the endothelium of grafted central cornea. The causes of opaque endothelial membrane of recipient were unexpected recipient penetrating keratoplasty (6 cases) and deep lamella keratoplasty with double chamber (4 cases).
Results
The opaque endothelial membrane was easily removed by The neodymium:YAG laser with low energy level (1.6 -2.0mJ). The mean impulses 45 35 and mean total energy was 73 29mJ. Well perforated central opening was confirmed by using AS-OCT and slit biomicroscopy. There was few inflammation in anterior chamber, endothelial loss, or elevation of intraocular pressure. Following a creation of a central opening with the Nd:YAG laser, visual acuity was improved in Two logMAR lines after treatment.
Conclusion
Removal of endothelial membrane using a Nd:YAG laser is safer and more convenient method than surgical method after penetrating and lamella keratoplasty.