Terry Mark A, Chen Edwin S, Shamie Neda, Hoar Karen L, Friend Daniel J
Corneal Services, Devers Eye Institute, Portland, Oregon 97210, USA.
Ophthalmology. 2008 Mar;115(3):488-496.e3. doi: 10.1016/j.ophtha.2007.10.035. Epub 2007 Dec 27.
To report the donor endothelial cell loss in the first year after Descemet's stripping endothelial keratoplasty (DSEK) for the treatment of endothelial dysfunction.
Prospective noncomparative interventional case series.
Eighty eyes of 78 patients with corneal edema.
Eighty eyes with endothelial failure were entered into a prospective study of endothelial keratoplasty (EK). The donor central endothelial cell density (ECD) was recorded postoperatively at 6 months (n = 80) and 12 months (n = 80) and then compared with the preoperative eye bank measurements. The subsets of eyes with the donor prepared manually (DSEK; n = 19) and the donor prepared with a microkeratome (Descemet's stripping automated EK [DSAEK]; n = 61) were also evaluated and compared.
Preoperative and postoperative central ECDs were prospectively evaluated and the cell loss calculated for each postoperative time point.
The average and standard deviation ECD at 6 months was 1908+/-354 cells/mm(2), representing a mean cell loss from preoperative donor cell measurements of 34+/-12%. At 12 months, ECD was 1856+/-371 cells/mm(2) (35+/-13% cell loss). The 1% additional cell loss from 6 to 12 months was not significant (P = 0.233). In the subset of DSEK eyes (n = 19), the cell loss from preoperatively to 6 months was 34%, and at 12 months it was 39%. In the subset of DSAEK eyes (n = 61), the cell loss from preoperatively to 6 months was 34%, and at 12 months it was 34%. There was no statistical difference between the cell loss from DSEK and that from DSAEK at 6 months (P = 0.884) or at 12 months (P = 0.224).
Descemet's stripping EK using our surgical technique has a mean donor endothelial cell loss of 34% at the 6-month postoperative examination, and this average cell loss remains relatively stable up to at least 1 year. We found no difference in cell loss between the DSEK and DSAEK techniques over this 1-year postoperative period.
报告用于治疗内皮功能障碍的后弹力层剥除内皮角膜移植术（DSEK）术后第一年供体内皮细胞的丢失情况。
前瞻性非对照干预性病例系列研究。
78例角膜水肿患者的80只眼。
80只内皮功能衰竭的眼睛进入内皮角膜移植术（EK）的前瞻性研究。术后6个月（n = 80）和12个月（n = 80）记录供体中央内皮细胞密度（ECD），然后与术前眼库测量值进行比较。还对人工制备供体的眼亚组（DSEK；n = 19）和使用微型角膜刀制备供体的眼亚组（后弹力层剥除自动内皮角膜移植术[DSAEK]；n = 61）进行了评估和比较。
前瞻性评估术前和术后中央ECD，并计算每个术后时间点的细胞丢失情况。
6个月时ECD的平均值和标准差为1908±354个细胞/mm²，相对于术前供体细胞测量值，平均细胞丢失率为34±12%。12个月时，ECD为1856±371个细胞/mm²（细胞丢失率为35±13%）。6至12个月额外1%的细胞丢失无统计学意义（P = 0.233）。在DSEK眼亚组（n = 19）中，术前至6个月的细胞丢失率为34%，12个月时为39%。在DSAEK眼亚组（n = 61）中，术前至6个月的细胞丢失率为34%，12个月时为34%。DSEK和DSAEK在6个月时（P = 0.884）或12个月时（P = 0.224）的细胞丢失率无统计学差异。
采用我们的手术技术进行后弹力层剥除EK术后6个月时，供体内皮细胞平均丢失率为34%，且至少到1年时这种平均细胞丢失率仍相对稳定。我们发现在术后1年期间，DSEK和DSAEK技术的细胞丢失率无差异。
