Endothelial keratoplasty to restore clarity to a failed penetrating graft
Endothelial keratoplasty to restore clarity to a failed penetrating graft
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DOI：
10.1097/01.ico.0000227888.03877.22
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发表时间：
2006-09-01
期刊：
影响因子：
2.8
通讯作者：
Price, Marianne O.
中科院分区：
文献类型：
--
作者：
Price, Francis W., Jr.;Price, Marianne O.
目的：为了描述适应的内皮角膜移植术，以恢复角膜透明度，以前的穿透性角膜移植术（PK）与内皮decompensation.Methods：一个外科医生的最初的7个连续的情况下，使用内皮角膜移植术治疗失败的前PK进行了回顾性分析。接受治疗的患眼在之前接受透明角膜移植后均发生了内皮失代偿。代替重复PK，将由后基质与后弹力膜和内皮组成的部分厚度供体纽扣移植到失败的全层供体移植物的后表面。在7例病例中的6例中，唯一的缝线是用于闭合5 mm巩膜隧道切口的缝线。供体按钮最初举行的地方与一个气泡，后来附在自己。结果：在所有情况下，新的供体按钮坚持和清除水肿从以前的穿透移植。在3个月内的内皮角膜移植术，最佳矫正视力提高了6 7例相比，术前view.Conclusion：标准PK通常需要数月至数年的愈合足以拆除缝线，并为患者提供一个稳定的屈光度和伤口强大到足以承受轻微的创伤。与重复PK相比，使用内皮角膜移植术修复失败的移植物可提供更快的视力恢复、结构更强的眼睛和更短的残疾期。内皮角膜移植术可能是一种特别有用的替代治疗穿透移植，达到可接受的屈光和眼表结果，但失败，因为内皮功能障碍。
Purpose: To describe an adaptation of endothelial keratoplasty to restore corneal clarity to a prior penetrating keratoplasty (PK) with endothelial decompensation.Methods: A surgeon's initial 7 consecutive cases using endothelial keratoplasty for treatment of failed prior PK were retrospectively analyzed. The treated eyes had all experienced endothelial decompensation after previously having clear corneal transplants. Instead of repeating the PK, a partial-thickness donor button, composed of posterior stroma with Descemet membrane and endothelium, was grafted to the posterior surface of the failed full-thickness donor graft. In 6 of the 7 cases, the only sutures were those used to close a 5-mm scleral tunnel incision. The donor button was initially held in place with an air bubble and later attached on its own.Results: In all cases, the new donor button adhered to and cleared the edema from the previous penetrating graft. Within 3 months of endothelial keratoplasty, best-corrected visual acuity had improved in 6 of the 7 cases compared with the preoperative vision.Conclusion: Standard PK usually takes months to years to heal sufficiently to remove sutures and provide patients with a stable refraction and a wound strong enough to withstand minor trauma. Using endothelial keratoplasty to rehabilitate a failed graft may provide faster visual recovery, a tectonically stronger eye, and a reduced period of disability compared with repeating the PK. Endothelial keratoplasty may be a particularly useful alternative for treating penetrating grafts that achieved acceptable refractive and ocular surface results but failed because of endothelial dysfunction.