Anterior Synechiolysis with Healon Needle and Ophthalmic Viscosurgical Devices after Anterior Lamellar Dissection in Penetrating Keratoplasty

<i>Purpose</i>: We described a technique to perform anterior synechiolysis with a healon needle and Viscoat® ophthalmic viscosurgical devices (OVDs) through anterior lamellar dissection in penetrating keratoplasty. <i>Methods</i>: OVDs were gently injected between iridocorneal adhesions with a healon needle to make a blunt dissection after anterior lamellar corneal dissection. Anterior synechiolysis at 360 degrees was completed with a healon needle and OVDs. Subsequently, the deep corneal lamella was cut with right and left Troutman-Katzin corneal scissors. 24 interrupted sutures were made with 10-0 nylon suture to implant the donor cornea. <i>Results</i>: In two eyes from two patients, with corneal opacity and nearly total anterior synechiae, clear grafts and relatively deep anterior chambers were achieved. Penetrating keratoplasty with anterior synechiolysis was thus successful with a healon needle and OVDs through lamellar dissection. <i>Conclusions</i>: Anterior synechiolysis with a healon needle and OVDs through lamellar dissection is a safe and efficient technique for keratoplasty in patients with corneal opacity with anterior synechiae.

<i>研究目的</i>：本研究描述了一种在穿透性角膜移植术中通过前板层剥离术，应用Healon针头（healon needle）与Viscoat®眼科黏弹剂（ophthalmic viscosurgical devices，OVDs）实施虹膜前粘连分离术的技术。<i>手术方法</i>：先行角膜前板层剥离，随后使用Healon针头将眼科黏弹剂轻柔注入虹膜角膜粘连间隙以完成钝性分离；采用Healon针头与眼科黏弹剂完成360°范围的虹膜前粘连分离。随后使用Troutman-Katzin角膜剪切断深层角膜板层，以10-0尼龙缝线完成24针间断缝合以植入供体角膜。<i>手术结果</i>：纳入2例患者共2只眼，均存在角膜混浊及近乎全周的虹膜前粘连，术后均获得透明的移植片与恢复良好的前房深度。综上，通过板层剥离术应用Healon针头与眼科黏弹剂实施虹膜前粘连分离的穿透性角膜移植术获得成功。<i>研究结论</i>：对于合并虹膜前粘连的角膜混浊患者，通过板层剥离术应用Healon针头与眼科黏弹剂实施虹膜前粘连分离是一种安全且高效的角膜移植手术技术。