Sindrom Urets-Zavalia nastao posle duboke prednje lamelarne keratoplastike
Sažetak
Uvod. Sindrom Urets-Zavalije je neuobičajena komplikacija posle operacije keratokonusa metodom duboke prednje lamelarne keratoplastike. Manifestacije ovog sindroma su trajna midrijaza, atrofija dužice i sekundarni glaukom. Prikaz bolesnika. Kod bolesnika starog 21 godinu, urađena je duboka prednja lamelarna keratoplastika sa keratokonusom i naizgled zaceljenim hidropsom rožnjače. Kalem je ostao providan, ali se operacija komplikovala trajnom midrijazom, poljima atrofije dužice, izvrnutim rubom pigmentnog sloja dužice i mrljastim zamućenjima ispod prednje kapsule sočiva (glaukomflecken). Zaključak. Mada bezbednija od perforativne keratoplastike, duboka prednja lamelarna transplantacija rožnjače nije bez komplikacija. Sindrom Urets-Zavalije može se izbeći ako se umesto zaptivanja otvora u Descemetovoj membrani pomoću vazduha, presadi nova Descemetova membrana zajedno sa kalemom, tehnikom perforativne keratoplastike.
Reference
Aggarwal R. Deep lamellar keratoplasty: An alternative for pe-netrating keratoplasty. Br J Ophthalmol 1997; 81(3): 178−9.
Urrets-Zavalia A Jr. Fixed, dilated pupil, iris atrophy and sec-ondary glaucoma. Am J Ophthalmol 1963; 56: 257−65.
Pouliquen Y, Ginmaraes R, Petroutsos G, Lacombe E. Le syndrome d'Urrets-Zavalia: existe-t-il encore. J Fr Ophtalmol 1983; 6: 325−6.
Giebel AW. Barosurgery, the surgical use of air, as a technique to promote adhesion between corneal layers in lamellar kera-toplasty. Tech Ophthalmol 2008; 6: 35–40.
Maurino V, Allan BD, Stevens JD, Tuft SJ. Fixed dilated pupil (Urrets-Zavalia syndrome) after air/gas injection after deep lamellar keratoplasty for keratoconus. Am J Ophthalmol 2002; 133(2): 266−8.
Minasian M, Ayliffe W. Fixed dilated pupil following deep la-mellar keratoplasty (Urrets-Zavalia syndrome). Br J Ophthal-mol 2002; 86(1): 115−6.
Spadea L, Viola M, Viola G. Regression of Urrets-Zavalia syn-drome after deep lamellar keratoplasty for keratoconus: A case study. Open Ophthalmol J 2008; 2: 130−1.
Niknam S, Rajabi MT. Fixed dilated pupil (Urrets-Zavalia syn-drome) after deep anterior lamellar keratoplasty. Cornea 2009; 28(10): 1187−90.
Bozkurt KT, Acar BT, Acar S. Fixed dilated pupilla as a com-mon complication of deep anterior lamellar keratoplasty com-plicated with Descemet membrane perforation. Eur J Oph-thalmol 2013; 23(2): 164−70.
Castroviejo R. Atlas of Keratectomy and Keratoplasty. Philadel-phia-London: WB Saunders Company; 1966. p. 336−7.
Uribe LE. Fixed pupil following keratoplasty: Evaluation of six cases. Am J Ophthalmol 1967; 63(6): 1682−6.
Tuft SJ, Buckley RJ. Iris ischaemia following penetrating kera-toplasty for keratoconus (Urrets-Zavalia syndrome). Cornea 1995; 14(6): 618−22.
Jain R, Assi A, Murdoch IE. Urrets-Zavalia syndrome following trabeculectomy. Br J Ophthalmol 2000; 84(3): 338−9.
Figueiredo GS, Kolli SS, Ahmad S, Gales K, Figueiredo FC. Urrets-Zavalia syndrome following penetrating keratoplasty for kera-toconus. Graefes Arch Clin Exp Ophthalmol 2013; 251(3): 809−15.
Fournié P, Ponchel C, Malecaze F, Arné J. Fixed dilated pupil (Ur-rets-Zavalia syndrome) and anterior subcapsular cataract for-mation after descemet stripping endothelial keratoplasty. Cor-nea 2009; 28(10): 1184−6.
Aralikatti AKV, Tomlins PJ, Shah S. Urrets-Zavalia syndrome following intracameral C3F8 injection for acute corneal hy-drops. Clin Experiment Ophthalmol 2008; 36(2): 198−9.
Yuzbasioglu E, Helvacioglu F, Sencan S. Fixed, dilated pupil after phakic intraocular lens implantation. J Cataract Refract Surg 2006; 32(1): 174−6.
Spierer O, Lazar M. Urrets-Zavalia syndrome (fixed and dilated pupil following penetrating keratoplasty for keratoconus) and its variants. Surv Ophthalmol 2014; 59(3): 304−10.