Saelens Isabelle E Y, Bartels Marjolijn C, Van Rij Gabriel
Department of Ophthalmology, Erasmus MC, Rotterdam, The Netherlands.
Cornea. 2008 Jul;27(6):673-8. doi: 10.1097/QAI.0b013e31815b69ae.
To report the outcome of posterior mushroom or top-hat-shaped keratoplasty for patients with Fuchs endothelial dystrophy (FED) or pseudophakic bullous keratopathy (PBK), concerning postoperative astigmatism, visual improvement, and endothelial cell density.
Twenty-two eyes of 21 patients who received a posterior mushroom keratoplasty for FED (n = 19) or PBK (n = 3) between March 2003 and January 2006 at the Erasmus MC, Rotterdam, The Netherlands, were included. Visual acuity, refraction, and keratometry were measured at 6, 12, 24, and 36 months. Specular microscopy was performed annually.
Best-corrected visual acuity (BCVA) significantly (P < 0.05) improved from 0.25 preoperatively to 0.47 at 6 months and 0.64 at 1 year postoperatively. Visual acuity remained stable with a BCVA of 0.62 2 years and 0.69 3 years after keratoplasty. At the last follow-up, the BCVA measured 0.5 or more in all but 2 (91%) eyes. Mean postoperative astigmatism at 1, 2, and 3 years measured 2.72 +/- 1.48, 2.69 +/- 1.85, and 1.75 +/- 1.76 D. Endothelial cell density averaged 2143 +/- 428 cells/mm2 at 1 year, 1539 +/- 573 cells/mm2 at 2 years, and 1920 +/- 474 cells/mm2 at 3 years. All studied transplants remained functional and clear throughout the follow-up period.
The posterior mushroom keratoplasty in FED and PBK results in a relatively good visual acuity, low astigmatism, and good endothelial cell density. The short-term results of our limited series of patients are encouraging.
报告采用后蘑菇状或礼帽状角膜移植术治疗Fuchs内皮营养不良（FED）或人工晶状体眼大泡性角膜病变（PBK）患者的术后散光、视力改善情况及内皮细胞密度。
纳入2003年3月至2006年1月在荷兰鹿特丹伊拉斯姆斯医学中心接受后蘑菇状角膜移植术治疗FED（n = 19）或PBK（n = 3）的21例患者的22只眼。在术后6、12、24和36个月测量视力、验光和角膜曲率。每年进行镜面显微镜检查。
最佳矫正视力（BCVA）从术前的0.25显著（P < 0.05）提高到术后6个月的0.47和术后1年的0.64。角膜移植术后2年BCVA为0.62，3年为0.69，视力保持稳定。在最后一次随访时，除2只眼（91%）外，所有眼的BCVA均测量为0.5或更高。术后1、2和3年的平均散光分别为2.72±1.48、2.69±1.85和1.75±1.76 D。内皮细胞密度在1年时平均为2143±428个细胞/mm²，2年时为1539±573个细胞/mm²，3年时为1920±474个细胞/mm²。在整个随访期间，所有研究的移植片均保持功能良好且透明。
FED和PBK患者行后蘑菇状角膜移植术可获得相对良好的视力、低散光和良好的内皮细胞密度。我们有限系列患者的短期结果令人鼓舞。
