Report The Clinical Effect Of Curing 1 Patient With Bulbous Keratopathy Through The Using "No-fold Technique" Of Descemet's Stripping Endothelial Keratoplasty(DSEK)

Objective:Report the clinical effect of curing 1 patient with bulbous keratopathy through the using "no-fold technique" of Descemet's stripping endothelial keratoplasty (DSEK)Methods:1 patient diagnosed with bulbous keratopathy in January 2009 in our hospital was chosen. Intraoperation, the donor graft was placed on the corneoscleral tunnel corresponding to the conjunctival surface(the form of non-folding), intraocular forceps of 23G was inserted into anterior chamber from the temporal corneal incision, and was stretched from the nasal corneoscleral tunnel. The endothelial graft was dragged into the anterior chamber by gripping the edge of it (no-fold technique). So far as postoperative follow-up (6 months), postoperative visual acuity,postoper-ative corneal graft,plant bed,endothelial,intraoperative and postoper-ative complications were recorded.Results:The patient had a successful surgery. Postoperative visual acuity gradually recovered, sterile air was completeiy absorbed for one week. Anterior segment OCT and slit lamp examination showed good adhesion of corneal graft and host cornea. There is no graft dislocation and high intraocular pressure. The eye's vision achieved naked visual acuity 0.4 after postoperation four month (corrected visual acuity is 0.5).There were no other complications in this follow-up period. Endothelial graft rejection occured after four and a half months because the patient stopped taking medicine himself. Good visual acuity was achieved by active drug treatment. So far, the eye's vision achieved naked visual acuity 0.5 (corrected visual acuity is 0.6). Corneal endothelium examinations had shown normal endothelium's shape and quantity.Conclusion:In this report,1 patient diagnosed with bulbous kerato-pathy was cured through the using "no-fold technique"of Descemet's stripping endothelial keratoplasty (DSEK).This technique reduce the loss rates of endothelial cell, low require the space of the anterior chamber and does not require special instrument. Compared with penetrating keratoplasty, the surgical procedure is the less risky, and no serious postoperative complications. Previously reports showed low incidence of endothelial graft rejection, patient in this report occurred the endothelial rejection after 4 and a half months. Patients with this type of operation should still be strict to prevent rejection by using anti-rejection drugs for long time. Long-term effect needs further study.