Clinical evaluation of a newly developed graft inserter (NS Endo-Inserter) for Descemet stripping automated endothelial keratoplasty
Clinical evaluation of a newly developed graft inserter (NS Endo-Inserter) for Descemet stripping automated endothelial keratoplasty
复制标题
DOI：
10.2147/opth.s182628
复制
发表时间：
2019-01-01
影响因子：
2.2
通讯作者：
Nishida, Kohji
中科院分区：
文献类型：
--
作者：
Soma, Takeshi;Koh, Shizuka;Nishida, Kohji
目的：本研究的目的是描述使用我们新开发的移植物插入器（NS Endo-Inserter）进行Descemet剥离自动内皮角膜移植术（DSAEK）的术后结果，并将结果与使用Busin滑动器进行的DSAEK进行比较。患者和方法：在这项回顾性、病例对照、机构性研究中，我们研究了使用NS ento - inserter （NS组，n=13）或Busin glide （Busin组，n=10）治疗角膜内皮功能障碍患者的DSAEK的临床结果。临床参数，包括距离矫正视力（DCVA）、内皮细胞（EC）损失和术中/术后并发症，在6个月的随访期间进行评估。结果：术后6个月，两组平均DCVA无显著差异。DSAEK后3和6个月的EC损失，NS组分别为9.1%+/- 20.7%和18.2%+/- 22.6%，Busin组分别为44.0%+/- 25.5%和46.5%+/- 23.3%；3个月和6个月时，组间差异均有统计学意义（P=0.024和P=0.016）。Busin组1例患者出现前房出血。Busin组有一只眼需要术后复泡。NS组无并发症发生。结论：我们新开发的DSAEK移植物插入器比传统的使用Busin滑动的拉穿技术造成的EC损伤要小得多。我们的植入器允许安全的内皮移植，没有前房塌陷，可以在手术后6个月成功地移植，没有并发症。
Purpose: The aim of this study was to describe the postoperative outcomes of Descemet stripping automated endothelial keratoplasty (DSAEK) performed using our newly developed graft inserter (NS Endo-Inserter) and compare the findings with those for DSAEK performed using the Busin glide.Patients and methods: In this retrospective, case-control, institutional study, we studied the clinical outcomes of DSAEK performed using the NS Endo-Inserter (NS group, n=13) or the Busin glide (Busin group, n=10) for patients with corneal endothelial dysfunction. Clinical parameters, including the distance-corrected visual acuity (DCVA), endothelial cell (EC) loss, and intraoperative/postoperative complications, were assessed over a 6-month follow-up period.Results: At 6 months after surgery, the mean DCVA showed no significant difference between the two groups. EC loss at 3 and 6 months after DSAEK was 9.1%+/- 20.7% and 18.2%+/- 22.6%, respectively, in the NS group and 44.0%+/- 25.5% and 46.5%+/- 23.3%, respectively, in the Busin group; differences between groups were statistically significant at both 3 and 6 months (P=0.024 and P=0.016, respectively). Anterior chamber hemorrhage was observed in one patient in the Busin group. Rebubbling after surgery was required for one eye in the Busin group. No complications were observed in the NS group.Conclusion: Our newly developed graft inserter for DSAEK may cause significantly less EC damage than the conventional pull-through technique using the Busin glide. Our inserter permits safe endothelial graft delivery without anterior chamber collapse and can result in successful graft attachment without complications at 6 months after surgery.