深層角膜移植術で角膜輪部よりデスメ膜を露出する方法

Exposure of the Descemet membrane through corneal limbal approach in deep lamellar keratoplasty

　角膜実質に混濁がある2眼に，角膜輪部よりデスメ膜を露出する方法を用いて深層角膜移植術を行った。トレパンで角膜表層の約4分の3を切除した後に，角膜輪部に3×4mmの強膜弁を作製し，シュレム管とデスメ膜を露出した。スパーテルでデスメ膜と角膜実質間を剥離し，その間にポリスチレンのシートを挿入した。角膜表面からシートに達するまで切開し，シートを除去してデスメ膜を露出させた。本法は，深層角膜移植術でデスメ膜を安全に露出させることに有用であった。

Deep lamellar keratoplasty was performed in 2 eyes with corneal stromal opacity. After three-fourths of the corneal stroma was excised with trephine, a 3×4 mm scleral flap was formed in the conreal limbus to expose the canal of Schlemm and Descemet membrane. The corneal stroma was then detached from the Descemet membrane with a spatula and a polystyrene sheet was inserted in-between. Thereafter, the cornea was incised as far as the sheet. The Descemet membrane was exposed after removal of the sheet. This procedure was useful in safely exposing the Descemet membrane in deep lamellar keratoplasty.