Descemet's stripping and non-Descemet's stripping automated endothelial keratoplasty for microcornea using 6.0 mm donor grafts.
Descemet's stripping and non-Descemet's stripping automated endothelial keratoplasty for microcornea using 6.0 mm donor grafts.
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DOI：
10.2147/opth.s50299
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Sugiyama K
中科院分区：
文献类型：
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作者：
Yokogawa H;Kobayashi A;Yamazaki N;Ueta Y;Hashimoto Y;Tachi N;Sugiyama K
本文旨在报告我们使用6.0 mm供体角膜移植片行后弹力层剥离和非后弹力层剥离自动内皮角膜移植术（DSAEK/nDSAEK）治疗小角膜的经验。两名患有小角膜和大泡性角膜病变的患者（一名56岁女性和一名59岁女性）的三只眼睛接受了DSAEK或nDSAEK治疗。使用双滑动（Busin滑动和眼内透镜片滑动）供体植入技术将小供体移植物（6.0 mm）插入前房。2例患者均随访至少12个月。评价临床结局，包括术中和术后并发症、视力和内皮细胞密度。在所有3例病例（100%）中，未观察到术中并发症。在1例角膜曲率测量值平坦（32.13 D）的病例中，术后第1天发现供体部分脱离，但通过再次鼓泡使其重新附着。在另一个病例中，术后8个月出现排斥反应，但全身皮质类固醇治疗成功。所有3例患者（100%）的角膜均保持透明，12个月时最佳矫正视力大于20/100（平均20/50）。术后6个月时平均内皮细胞计数为2，603 ± 18个细胞/mm 2（较术前供体细胞计数减少7.4%），12个月时为1，799 ± 556个细胞/mm 2（减少36.5%）。我们首次报告了成功使用小供体移植物（6.0 mm）用于DSAEK/nDSAEK的微小角膜病例。需要对大量患者进行进一步的研究，以充分评价小直径供体移植物用于小角膜的潜在优点和缺点。
The purpose of this paper is to report our experience of Descemet’s stripping and non-Descemet’s stripping automated endothelial keratoplasty (DSAEK/nDSAEK) for microcorneas using 6.0 mm donor grafts. Three eyes of two patients (a 56-year-old woman and a 59-year-old woman) with microcornea and suffering from bullous keratopathy were treated with either DSAEK or nDSAEK. A small donor graft (6.0 mm) was inserted into the anterior chamber using a double glide (Busin glide and intraocular lens sheet glide) donor insertion technique. Both patients were followed for at least 12 months. Clinical outcomes, including intraoperative and postoperative complications, visual acuity, and endothelial cell density were evaluated. In all three cases (100%), no intraoperative complications were noted. In one case with a flat keratometry value (32.13 D), a partial donor detachment was noted one day postoperatively, but it was reattached by rebubbling. In another case, rejection was noted 8 months postoperatively, but treatment with systemic corticosteroids was successful. A clear cornea remained in all three cases (100%), with best-corrected visual acuity greater than 20/100 (mean 20/50) at 12 months. Mean postoperative endothelial cell counts were 2,603 ± 18 cells/mm2 at 6 months (7.4% decrease from preoperative donor cell counts) and 1,799 ± 556 cells/mm2 at 12 months (36.5% decrease). We report for the first time the successful use of a small donor graft (6.0 mm) for DSAEK/nDSAEK in cases of microcornea. Additional stud ies using a large number of patients are required to evaluate fully the potential advantages and drawbacks of small diameter donor grafts for microcornea.