Nieuwendaal Carla P, van Velthoven Mirjam E J, Biallosterski Carine, van der Meulen Ivanka J E, Lapid-Gortzak Ruth, Melles Gerrit R J, Verbraak Frank D
Department of Ophthalmology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Cornea. 2009 Apr;28(3):298-303. doi: 10.1097/ICO.0b013e318189135f.
To evaluate donor posterior disk thickness measured with anterior segment optical coherence tomography after Descemet stripping endothelial keratoplasty.
Fifteen patients (17 eyes) after Descemet stripping endothelial keratoplasty, using manually dissected donor posterior disks, were measured with the Visante anterior segment optical coherence tomography (Carl Zeiss Meditec Inc, Dublin, CA). Optical coherence tomography scans were made in a radial pattern, 45 degrees apart, starting in the horizontal axis. Thickness measurements of the donor posterior disks were taken centrally and at fixed radii toward the periphery and were correlated to postoperative change in spherical equivalent (SE), best-corrected visual acuity (BCVA, in Snellen), and improvement in BCVA.
Median BCVA was 20/30 (range 20/60-20/20) postoperatively. Median postoperative improvement in BCVA was 4 lines (range 1-11). Median follow-up time was 15.5 months (range 6-32 months). Median postoperative change in SE was -0.25 diopters (range -4.25 to +3.00 diopters). Median central disk thickness was 128.3 microm (range 55-181 microm) and increased significantly toward the periphery: median disk thickness at the 1.5 mm radius was 140.8 microm (range 72-199 microm) and at the 3.0 mm radius was 161.5 microm (range 102-245 microm). No correlation was found between (central) donor disk thickness and postoperative BCVA or change in SE. A nonstatistically significant trend was seen toward more improvement in BCVA with thinner donor disks.
Optical coherence tomography measurements of the manually dissected donor posterior disk showed significant variation in thickness, without a statistically significant effect on postoperative BCVA or improvement thereof. Central thickness varied significantly from the peripheral thickness within donor posterior disk.
评估在Descemet膜剥除内皮角膜移植术后使用眼前节光学相干断层扫描测量的供体后弹力层厚度。
对15例(17只眼)接受Descemet膜剥除内皮角膜移植术且使用手动剖切的供体后弹力层的患者,采用Visante眼前节光学相干断层扫描仪(卡尔蔡司医疗技术公司,加利福尼亚州都柏林)进行测量。光学相干断层扫描以放射状模式进行,相隔45度,从水平轴开始。在供体后弹力层的中央及向周边的固定半径处测量厚度,并与术后等效球镜度(SE)的变化、最佳矫正视力(BCVA,以Snellen视力表表示)及BCVA的改善情况进行相关性分析。
术后BCVA中位数为20/30(范围20/60 - 20/20)。术后BCVA改善的中位数为4行(范围1 - 11行)。中位随访时间为15.5个月(范围6 - 32个月)。术后SE的中位数变化为-0.25屈光度(范围-4.25至+3.00屈光度)。中央后弹力层厚度中位数为128.3微米(范围55 - 181微米),并向周边显著增加:半径1.5毫米处的后弹力层厚度中位数为140.8微米(范围72 - 199微米),半径3.0毫米处为161.5微米(范围102 - 245微米)。未发现(中央)供体后弹力层厚度与术后BCVA或SE变化之间存在相关性。供体后弹力层越薄,BCVA改善越明显,但差异无统计学意义。
对手动剖切的供体后弹力层进行光学相干断层扫描测量显示厚度存在显著差异,对术后BCVA或其改善情况无统计学意义上的显著影响。供体后弹力层中央厚度与周边厚度差异显著。