New Graft Insertion Device for Descemet Stripping Automated Endothelial Keratoplasty.
New Graft Insertion Device for Descemet Stripping Automated Endothelial Keratoplasty.
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用于后弹力层剥离自动内皮角膜移植术的新型移植物插入装置。
DOI：
10.1097/ico.0000000000001302
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发表时间：
2017
期刊：
影响因子：
2.8
通讯作者：
Soma T
中科院分区：
文献类型：
--
作者：
Soma T
目的：角膜内皮功能障碍是全球角膜移植手术的主要适应症，尽管通过一系列后板层手术进行手术干预已被证明是非常有益的，但挑战仍然存在。在前房相对较浅的情况下尤其如此，亚洲人群的情况经常如此，但并非完全如此。在这项研究中，我们介绍了一种新的插入装置，以提供角膜移植组织的后弹力层剥离自动内皮角膜移植术（DSAEK）。方法：一种新的手术工具的设计和制造，使一步插入角膜移植组织到前房的基础上的压力流的概念，而不是一个拉通过一个。这是测试离体评估内皮细胞损伤，然后在12个第一次在人体surgery.Results：预切DSAEK植入供体角膜离体通过新技术表明，较少的内皮细胞损伤发生相比，拉通过技术。移植物是成功的，在所有患者接受新的手术，没有原发性移植failure.Conclusions的情况下：新开发的DSAEK插入器是一个简单而有用的工具，内皮移植物输送，减少术中对移植组织的机械应力。
Purpose:Corneal endothelial dysfunction is a major indication for corneal graft surgery worldwide, and although surgical intervention through a range of posterior lamellar surgeries has proven to be hugely beneficial, challenges remain. This is especially so where the anterior chamber is relatively shallow, as is often the case in the Asian population, though not exclusively so. In this study, we introduce a new insertion device to deliver endothelial graft tissue for Descemet stripping automated endothelial keratoplasty (DSAEK).Methods:A new surgical tool was designed and manufactured so as to enable a 1-step insertion of corneal graft tissue into the anterior chamber based on a pressure–flow concept, rather than the a pull-through one. This was tested ex vivo to assess endothelial cell damage, and then performed in 12 first-in-human surgeries.Results:Precut DSAEK lenticules implanted in donor corneas ex vivo through the new technique showed that less endothelial cell damage occurs compared with a pull-through technique. Grafts were successful in all patients receiving the new surgery, with no cases of primary graft failure.Conclusions:The newly developed DSAEK inserter is a simple and useful tool for endothelial graft delivery, lessening intraoperative mechanical stress on the graft tissue.