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목적: 백내장수술 중 발생한 데스메막박리의 경우 전방으로 비팽창성 육불화황(18% SF6) 가스를 주입하거나 간헐적인 각막봉합술로데스메막유착을 경험하였기에 문헌고찰과 함께 보고하고자 한다. 증례요약: 증례 1) 74세 여자, 좌안 백내장수술 후, 수술 1일째 데스메막박리가 관찰되었다. 술 후 안전수동의 시력을 보여, 18% SF6 가스를 전방 내에 주입하여 각막부종 소실과 데스메막유착으로 시력호전을 보였다. 증례 2) 76세 남자, 타 안과에서 3개월 전에 백내장수술 후, 각막중심부의 데스메막주름과 박리에 의한 시력저하로 내원하였다. 두 차례 18% SF6 가스를 전방에 주입하여 증상 호전을보였다. 증례 3) 75세 여자, 우안 백내장수술 후 1일째 데스메막박리가 관찰되었다. 전방에 18% SF6 가스를 두 차례 주입하였으나동공차단이 발생하였고, 증상 호전이 없어 데스메막박리가 가장 심한 부위에 각막봉합술을 실시하여 각막부종의 소실과 데스메막유착을 얻었다. 결론: 백내장수술 후 데스메막박리가 관찰되면, 전방 내 18% SF6 가스를 0.3-0.4 mL를 주입하거나, 각막봉합술을 시행하여 데스메막유착을 얻을 수 있었다.
Purpose: We report the therapeutic efficacy of using 18% SF6 injection into the anterior chamber or interrupted corneal sutures for Descemet membrane detachment related to cataract surgery. Case summary: Case 1) A 74-year-old female showed localized detachment of Descemet membrane of the cornea on the first day after cataract surgery on the left eye; her visual acuity was hand motion only. Non-expansible sulfur hexafluoride (18% SF6) gas was injected into the anterior chamber to treat the detachment and achieved improvement of vision due to relief of the corneal edema and adhesion of the Descemet membrane. Case 2) A 76-year-old male had poor visual acuity of the right eye after cataract surgery performed at a local eye clinic. Folding and detachment of the Descemet membrane was found before the postoperative 3-months follow-up. We injected 0.3 mL 18% SF6 gas into the anterior chamber twice. The corneal edema disappeared and visual acuity improved. Case 3) A 75-year-old female who had undergone cataract surgery was suspected of having Descemet membrane detachment. She was injected with 18% SF6 into the anterior chamber twice, but the detached membrane persisted in the lower right cornea, combined with pupillary block glaucoma. We performed interrupted corneal sutures of the detached Descemet membrane, and resolution of the detachment was confirmed by corneal optical coherence tomography. Conclusions: Re-attachment of Descemet membrane of the cornea can be obtained by performing repeated injections of 0.3-0.4 mL of non-expansible 18% SF6 gas, or by direct corneal suture in cases of persistent detachment.
