デスメ膜非剥離角膜内皮移植術(nDSAEK)後における角膜および視機能の解析

非后弹力层脱离内皮角膜移植术（nDSAEK）后角膜和视功能的分析

• 批准号: 25931057
• 负责人: 正木 利憲
• 金额: $ 0.38万
• 依托单位: やわたメディカルセンター
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Encouragement of Scientists
• 财政年份: 2013
• 资助国家: 日本
• 起止时间: 2013-04-01 至 2014-03-31
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-25931057/
• 关键词: nDSAEK; trabeculectomy; 角膜内皮移植

本年度は、線維柱体切除術(trabeculectomy)施行後の濾過胞眼症例に対する角膜内皮移植術(nDSAEK)術後の他覚的視機能の解析を行った。nDSAEK施行後の濾過胞眼症例10眼と非濾過胞限症例51眼を対象とし、術中術後合併症の有無や種類、術後視力と角膜内皮細胞密度(術後6ヶ月、1年、2年)について比較検討した。10眼中2眼は術後1年～2年の間に再移植を必要とした。濾過胞眼症例の平均角膜内皮細胞密度(/㎟)は、術前2877 (n=10)、術後6ヶ月2422 (16%減少、n=10)、術後1年1947 (33%減少、n=10)、術後2年1225 (60%減少、n=8)であり、非濾過胞眼症例(n=51)では、術前2827、術後6ヶ月2189 (23%減少)、術後1年1991 (30%減少)、術後2年1717 (39%減少)であった。非濾過胞眼症例(51例)と比較して、術前、術後6か月、術後1年では2群間に有意差はみられなかったが、術後2年では2群間に有意差がみられた。濾過胞眼症例の平均矯正視力LogMARは、術前0.88LogMAR (n=10)、術後6ヶ月0.50LogMAR (n=10)、術後1年0.45LogMAR (n=10)、術後2年0.44LogMAR (n=8)であり、非濾過胞眼症例(n=51)では. 術前1.03LogMAR、術後6ヶ月0.30LogMAR、術後1年0.28LogMAR、術後2年0.25LogMARであった。非濾過胞眼症例(51例)と比較して、平均矯正視力LogMARは全期間において両群間に有意差はみられなかった。濾過胞眼症例に対してのnDSABKの術後中期成績は、術後2年で約60%の内皮細胞の減少があり、約20%で再移植を必要としたことから、今後も長期に渡りさらに臨床成績が悪化する可能性があると示唆された。

This year, the patients with cytopathic ophthalmopathy were treated with trabeculectomy. The patients who underwent corneal endothelial transplantation (nDSAEK) were able to analyze the performance of other patients. After nDSAEK, there were 10 eyes with cytophthalmia and 51 eyes with non-atypical cytopenia. The corneal endothelial cell density (6 months, 1 year and 2 years after operation) was measured and compared. In 10 eyes, 2 eyes were retransplanted after 1 year to 2 years. The average corneal endothelial cell density was 2877 before surgery, 2422 at 6 months after surgery, 1947 at 1 year after surgery, 1225 at 2 years after surgery, 2827 before surgery, 2189 at 6 months after surgery, 1991 at 1 year after surgery, 1991 at 6 months after surgery, and 1991 at 1 year after surgery. 1717 yuan (39% less) in the following 2 years. In 51 cases of non-perinephthalmia, there were significant differences between pre-operation, 6 months after operation, 1 year after operation and 2 years after operation. The average LogMAR, 0.88LogMAR before surgery, 0.50LogMAR at 6 months after surgery, 0.45LogMAR at 1 year, 0.44LogMAR at 8 years after operation, and non-phthalmia at 2 years after operation were significantly higher in the patients with ectopic ophthalmopathy. 1.03LogMAR before surgery, 0.30LogMAR after 6 months, 0.28LogMAR at 1 year, 0.25LogMAR at 2 years after surgery. 51 cases of non-ectopic ophthalmopathy (51 cases) were compared with each other, and the average positive force of LogMAR was significantly higher than that of the control group during the whole period. The patients with cytophagia were diagnosed with nDSABK after mid-term pregnancy, about 60% of them had fewer endothelial cells in the next 2 years, and about 20% of them had to be re-transplanted for a long time.