Therapeutics and Clinical Risk Management (Dec 2017)
Regarding the descemetorhexis for anterior synechiolysis prior to endothelial keratoplasty
Abstract
Sang Beom Han Department of Ophthalmology, Kangwon National University Hospital, Kangwon National University Graduate School of Medicine, Chuncheon, Republic of KoreaWe read with great interest the article by Droutsas et al1 entitled “Isolated descemetorhexis for anterior synechiolysis prior to endothelial keratoplasty – case report and technique.” The authors introduced an interesting case in which isolated descemetorhexis was first performed for the management of flat anterior chamber and extensive iridocorneal synechiae, and subsequently Descemet stripping endothelial keratoplasty (EK) was successfully done for visual rehabilitation.1 This stepwise approach is expected to be helpful for restoration and maintenance of corneal clarity.1 The authors also employed an useful method of scoring of Descemet’s membrane by using a reverse Sinskey hook (D.O.R.C., Zuidland, the Netherlands) after filling the anterior chamber with air. As previous studies have suggested, Descemet’s membrane stripping under air, instead of viscoelastic material, can improve visualization, even in corneal opacity due to bullous keratopathy.2,3 We believe the technique was helpful for preventing damage to adjacent tissue and reducing postoperative inflammation. Authors’ replyK Droutsas,1,2 K Andreanos,1 A Lazaridis,2 I Georgalas,1 G Kymionis,1,3 D Papaconstantinou1 1First Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece; 2Ophthalmology Department, Philipps University Marburg, Marburg, Germany; 3Ophthalmology Department, Jules Gonin Eye Hospital, University of Lausanne, Lausanne, SwitzerlandWe would like to thank Dr Han for the valuable comments on our article entitled “Isolated descemetorhexis for anterior synechiolysis prior to endothelial keratoplasty – case report and technique.”View the original paper by Droutsas and colleagues.
