Comparison of 5-Year Clinical Results of Descemet and Non-Descemet Stripping Automated Endothelial Keratoplasty.
Comparison of 5-Year Clinical Results of Descemet and Non-Descemet Stripping Automated Endothelial Keratoplasty.
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DOI：
10.1097/ico.0000000000002211
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发表时间：
2019-11
期刊：
影响因子：
2.8
通讯作者：
Takashi Omoto;Tetsuya Toyono;Tatsuya Inoue;R. Shirakawa;Junko Yoshida;Takashi Miyai;S. Yamagami;T. Usui
中科院分区：
文献类型：
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作者：
Takashi Omoto;Tetsuya Toyono;Tatsuya Inoue;R. Shirakawa;Junko Yoshida;Takashi Miyai;S. Yamagami;T. Usui
目的比较非后弹力层剥脱式自动内皮角膜移植术（nDSAEK）和DSAEK的5年临床效果。方法：回顾性图表审查涉及非Fuchs型大泡性角膜移植患者，他们在审查前5年接受了nDSAEK或DSAEK，对人口统计学，移植物存活率，内皮细胞密度（ECD），最佳矫正视力（BCVA）和并发症进行了审查。结果50只眼（nDSAEK 28只眼，DSAEK 22只眼）纳入研究。手术的常见适应症是青光眼引起的大泡性角膜病变、白内障手术或激光虹膜切开术。nDSAEK和DSAEK眼1、3、5年的移植物存活率分别为0.75和0.86、0.67和0.81、0.59和0.74。nDSAEK和DSAEK眼的平均供体ECD分别为2638和2503个细胞/mm;在1、3和5年时分别降至1654和1406、1503和1218以及1108和1020个细胞/mm。nDSAEK和DSAEK眼的平均术前BCVA分别为1.08和1.11 LogMAR;在1、3和5年时分别改善至0.238和0.190、0.126和0.157以及0.097和0.070 LogMAR。最常见的并发症是眼压升高。nDSAEK和DSAEK在移植物存活率、ECD和BCVA的变化或术后并发症的发生方面没有统计学显著差异，除了2年时ECD的变化（1173和1193个细胞/mm，P = 0.0159）。结论：nDSAEK和DSAEK的5年临床结果几乎在所有点上都没有显示出显著差异。
PURPOSE To compare 5-year clinical results of non-Descemet stripping automated endothelial keratoplasty (nDSAEK) and DSAEK. METHODS A retrospective chart review involving patients with non-Fuchs-type bullous keratoplasty who underwent nDSAEK or DSAEK 5 years before the review was performed on demographics, graft survival rate, endothelial cell density (ECD), best-corrected visual acuity (BCVA), and complications. RESULTS Fifty eyes (nDSAEK 28, DSAEK 22) were included in this study. Common indications for surgery were bullous keratopathy due to glaucoma, cataract surgeries, or laser iridotomy. The graft survival rates in nDSAEK and DSAEK eyes at 1, 3, and 5 years were 0.75 and 0.86, 0.67 and 0.81, and 0.59 and 0.74, respectively. The mean donor ECDs of nDSAEK and DSAEK eyes were 2638 and 2503 cells/mm, respectively; these decreased to 1654 and 1406, 1503 and 1218, and 1108 and 1020 cells/mm at 1, 3, and 5 years, respectively. The mean preoperative BCVAs of nDSAEK and DSAEK eyes were 1.08 and 1.11 LogMAR, respectively; these improved to 0.238 and 0.190, 0.126 and 0.157, and 0.097 and 0.070 LogMAR at 1, 3, and 5 years, respectively. The most common complication was intraocular pressure elevation. There were no statistically significant differences between nDSAEK and DSAEK in graft survival rates, changes in ECD and BCVA, or the occurrence of postoperative complications, with the exception of the change in ECD at 2 years (1173 and 1193 cells/mm, P = 0.0159). CONCLUSIONS Our 5-year clinical results of nDSAEK and DSAEK did not show significant differences at almost all points.