J Korean Ophthalmol Soc.  2014 Sep;55(9):1388-1391. 10.3341/jkos.2014.55.9.1388.

A Case of Anterior Synechiolysis with Lamellar Corneal Dissection in Penetrating Keratoplasty

• Sung YM
• Kim EC

• KMID: 2217127
• DOI: http://doi.org/10.3341/jkos.2014.55.9.1388

Abstract

PURPOSE
To report a case of anterior synechiolysis with lamellar corneal dissection in penetrating keratoplasty.
CASE SUMMARY
In an eye with graft failure and anterior synechiae, we performed anterior synechiolysis with a healon needle after lamellar dissection using vacuum trephine to visualize the anterior chamber during penetrating keratoplasty. Additionally, the remnant corneal layer was removed using corneal scissors. A donor cornea was harvested using a vacuum trephine and the corneal button was sewn in place with 10-0 nylon. We observed a well grafted cornea and well formed anterior chamber with no anterior synechiae observed on follow-up.
CONCLUSIONS
In patients with anterior synechiae, the cornea can be dissected from the anterior synechiae completely using lamellar corneal dissection in penetrating keratoplasty to visualize the anterior chamber.

Keyword

Anterior synechiae; Lamellar corneal dissection; Penetrating keratoplasty; Synechiolysis

MeSH Terms

Anterior Chamber
Cornea
Follow-Up Studies
Humans
Hyaluronic Acid
Keratoplasty, Penetrating*
Needles
Nylons
Tissue Donors
Transplants
Vacuum
Hyaluronic Acid
Nylons

Figure

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  Figure 1. (A) Host cornea before surgery. (B) Corneal endothelium microscopy before surgery (the figure 3225 in the result was miscounted). (C) Anterior segment photography on 1 month postoperatively. (D) Well formed anterior chamber after surgery on 1 month postoperatively.

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  Figure 2. (A) Initial cut on the host cornea using vacuum trephine. (B) Cross-sectional view of (A). (C) Lamellar dissection using beaver blade. (D) Cross-sectional view after lamellar dissection. (E) Anterior synechiolysis using healon needle. (F) Cross-sectional view of (E).

Reference

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