PMC9750096_01
Ocular finding of the intracorneal hematoma under the Descemet membrane. (A) Intracorneal hematoma covering the pupillary area on the first visit to our hospital. (B) Ocular image of the same eye taken from the temporal side. (C) At 4 months after the surgery, the pupillary area became transparent, although few corneal stroma opacites remained between the layers. (D) Anterior segment OCT showing intracorneal hematoma under the Descemet membrane at the first visit. (E) Image of the anterior segment OCT 4 months after the surgery. No intracorneal hematoma was observed 4 months after the treatment. OCT, optical coherence tomography.
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F1
We observed neovascularization in the deep corneal layer from the upper corneal limbus, and a circular intracorneal hematoma in the central part of the deep corneal stroma (Fig. 1A,B). Aichi, Japan) revealed a hematoma under the Descemet membrane in the central part of the cornea, with a disk-shaped high-intensity area in the center (Fig. 1D). The density of corneal endothelial cells was 2,506 cells per square millimeter in the right eye and was unmeasurable in the left eye. Although the examination for posterior pole was disturbed by intracorneal hematoma, peripheral retina seemed to be normal under mydriasis. Four months after the operation, a few corneal stroma opacities remained between the layers (Fig. 1C,E), and the density of corneal endothelial cells in the left eye was measurable (913 cells/mm2).
Surgical methods for anterior chamber gas tamponade combined with keratocentesis. (A) Cauterization of vessels in the superior corneal limbus. (B) Injection of filtered gas into the anterior chamber with a 32-G needle. (C) Keratocentesis with a 24-G V lance needle from the corneal epithelium to the stroma. (D) Scraping the cornea with a spatula to remove the hematoma between the layers by means of puncture.
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F2
The steps of the surgical procedure were as follows: (1) vascular ablation of the upper corneal limbus was performed (Fig. 2A); (2) filtered room air was injected into the anterior chamber with a 32-G needle to increase and maintain the intraocular pressure for the removal of the intracorneal blood, referring to the procedure in Descemet membrane endothelial keratoplasty (DSAEK) when accumulated fluid between the donor and host was removed (Fig. 2B); (3) four keratocentesis was performed with a 24-G V lance needle from the corneal epithelium to the stroma (Fig. 2C); (4) the hematoma was displaced between the layers and removed through the puncture sites by scraping the cornea with a spatula (Fig. 2D), and a balanced saline solution was injected into the anterior chamber to replace filtered air; and (5) a soft contact lens (SCL) (Air Optix Ex