Evolving Techniques and Indications of Descemet Membrane Endothelial Keratoplasty.
Evolving Techniques and Indications of Descemet Membrane Endothelial Keratoplasty.
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后弹力层内皮角膜移植术的技术发展和适应症。
DOI：
10.4274/tjo.galenos.2021.28227
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发表时间：
2021-12-28
影响因子：
--
通讯作者：
Melles G
中科院分区：
文献类型：
--
作者：
Kemer ÖE;Karaca EE;Oellerich S;Melles G
内皮角膜移植术已取代传统的穿透性角膜移植术治疗角膜内皮功能障碍。它提供了更快、更可预测、稳定的视力恢复和低排异率，而手术本身的侵入性更小。Descemet膜内皮角膜移植术（DMEK）是目前治疗Fuchs内皮营养不良、大疱性角膜病变和白内障术后角膜水肿的金标准。越来越多的大型研究小组报道了其良好的长期结果。本文综述了目前关于DMEK新技术的文献，包括尺寸和形状的改变，新的移植物输送技术，以及青光眼，青光眼管和穿透性角膜移植术失败等挑战性病例的手术珍珠。
Endothelial keratoplasty has replaced traditional penetrating keratoplasty for the treatment of corneal endothelial dysfunction. It offers faster, more predictable, stable visual recovery and low rejection rates while the surgery itself is less invasive. Descemet membrane endothelial keratoplasty (DMEK) is currently the gold standard for the treatment of Fuchs endothelial dystrophy, bullous keratopathy, and corneal edema after cataract surgery. Its favorable long-term outcomes are increasingly reported by large study groups. This review summarizes the current literature on new DMEK techniques, including size and shape modifications, new graft delivery techniques, and surgical pearls for challenging cases like eyes with glaucoma, glaucoma tubes, and failed penetrating keratoplasties.