Cursiefen C, Kruse F E
Augenklinik mit Poliklinik, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen.
Ophthalmologe. 2009 Oct;106(10):939-52; quiz 953. doi: 10.1007/s00347-009-2024-z.
Penetrating keratoplasty has been the gold standard for the surgical treatment of corneal endothelial pathologies, but tremendous progress has been made in recent years in improving the technology of posterior lamellar keratoplasty techniques such as Descemet's stripping automated endothelial keratoplasty (DSAEK). This progress is shown by a literature review using PubMed sources and our own clinical and experimental data. Posterior lamellar keratoplasty using a microkeratome is a reliable surgical technique for Fuchs' endothelial dystrophy and pseudophakic bullous keratopathy. Visual rehabilitation is faster with lamellar compared with penetrating keratoplasty, but final visual acuity seems to be a bit reduced. Posterior lamellar keratoplasty techniques such as DSAEK may replace penetrating keratoplasty as the gold standard for treating a large proportion of corneal endothelial pathologies.
穿透性角膜移植术一直是角膜内皮病变外科治疗的金标准,但近年来在改进后板层角膜移植技术(如Descemet膜剥脱自动内皮角膜移植术,DSAEK)方面取得了巨大进展。使用PubMed来源进行的文献综述以及我们自己的临床和实验数据表明了这一进展。使用微型角膜刀进行后板层角膜移植术是治疗Fuchs内皮营养不良和人工晶状体性大泡性角膜病变的可靠手术技术。与穿透性角膜移植术相比,板层角膜移植术的视力恢复更快,但最终视力似乎会有所降低。诸如DSAEK等后板层角膜移植技术可能会取代穿透性角膜移植术,成为治疗大部分角膜内皮病变的金标准。