Descemet's Stripping Endothelial Keratoplasty Five-Year Graft Survival and Endothelial Cell Loss
Descemet's Stripping Endothelial Keratoplasty Five-Year Graft Survival and Endothelial Cell Loss
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DOI：
10.1016/j.ophtha.2010.08.012
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发表时间：
2011-04-01
期刊：
影响因子：
13.7
通讯作者：
Price, Francis W., Jr.
中科院分区：
文献类型：
--
作者：
Price, Marianne O.;Fairchild, Kelly M.;Price, Francis W., Jr.
目的：评估5年后弹力层剥脱内皮角膜移植术（DSEK）移植物存活率和存活grafts.Design的内皮细胞损失：回顾性，干预性病例系列。参与者：149例患者的165只眼接受原发性DSEK.Methods：供体角膜巩膜缘手动或用微型角膜刀解剖，并用环锯切割。将移植物内皮侧向内折叠，并通过5 mm切口用镊子插入。使用Kaplan-Meier生存分析和对数秩检验计算继发性移植物失效的累积概率。内皮细胞密度（ECD）从基线术前供体和1年，3年，5年术后中央内皮images.Main Outcome Measures：移植物存活率和ECD在5 years.Results：中位受体年龄为71岁（范围，22-90岁）和62%是女性。18只眼（11%）接受了人工晶状体或无晶状体角膜水肿治疗，147只眼（89%）接受了Fuchs营养不良治疗。人工晶状体或无晶状体角膜水肿眼的累积5年生存率（76%）显著低于Fuchs眼（95%; P = 0.0087）。特别是，与未接受青光眼分流术或小梁切除术的患者相比，接受过青光眼分流术或小梁切除术的患者的5年生存率显著降低（40%比95%; P
Purpose: To assess 5-year Descemet's stripping endothelial keratoplasty (DSEK) graft survival and endothelial cell loss in the surviving grafts.Design: Retrospective, interventional case series.Participants: One hundred sixty-five eyes of 149 patients treated with primary DSEK.Methods: Donor corneal-scleral rims were dissected manually or with a microkeratome and were cut with a trephine. The graft was folded endothelial side inward and was inserted with forceps through a 5-mm incision. The cumulative probability of secondary graft failure was calculated using Kaplan-Meier survival analysis and the log-rank test. Endothelial cell density (ECD) was determined from baseline preoperative donor and 1-year, 3-year, and 5-year postoperative central endothelial images.Main Outcome Measures: Graft survival and ECD at 5 years.Results: The median recipient age was 71 years (range, 22-90 years) and 62% were female. Eighteen eyes (11%) were treated for pseudophakic or aphakic corneal edema and 147 eyes (89%) were treated for Fuchs' dystrophy. The cumulative 5-year survival rate was significantly lower in pseudophakic or aphakic corneal edema eyes (76%) versus Fuchs' eyes (95%; P = 0.0087). In particular, the 5-year survival rate was reduced significantly in eyes with prior glaucoma shunt or trabeculectomy surgery vs. those without (40% vs. 95%; P