[自动角膜内皮移植术联合后弹力层剥除的临床研究]

[Clinical study of Descemet membrane stripping with automated endothelium keratoplasty].

作者信息

Hong Jing, Hao Yan-sheng, Ma Zhi-zhong, Wang Yan-qing, Liu Jing, Chen Xue

机构信息

Peking University Eye Center, Peking University Third Hospital, Beijing 100191, China.

出版信息

Zhonghua Yan Ke Za Zhi. 2010 Jan;46(1):7-12.

PMID:20388315

Abstract

OBJECTIVE

To investigate the clinical efficacy, prevention and management complications and choice of indication with Descemet membrane stripping with automated endothelium keratoplasty (DSAEK).

METHODS

Clinical case series. Nine patients (9 eyes) with bullous keratopathy underwent DSAEK procedure from Peking University Eye Center, Peking University Third Hospital during September to December in 2007. Visual acuity, cornea transparency, graft position, corneal thickness, curvature, astigmatism and endothelial cells density (ECD) were observed over 3-7 month follow-up period.

RESULTS

One patient with iris cornea endothelium syndrome was fail to insert graft into anterior chamber and changed procedure to penetrating keratoplasty. Eight patient successfully performed procedure. One graft dislocation in was managed in first day after surgery. All 8 grafts remained transparent and improved visual acuity. After surgery, mean corneal thickness was (775 +/- 30)microm. Mean corneal curvature was (44.19 +/- 2.28) D. Mean corneal astigmatism was (2.20 +/- 0.83) D. Mean endothelial cells density was (1439 +/- 296) cells/mm(2).

CONCLUSIONS

DSAEK is a less damage, faster recovery vision, safer procedure. It is expected to be the important procedure to treat bullous keratopathy.

摘要

目的

探讨自动角膜内皮移植术（DSAEK）中后弹力层剥除的临床疗效、并发症的预防及处理以及适应证的选择。

方法

临床病例系列研究。2007年9月至12月期间，北京大学第三医院北京大学眼科中心对9例（9眼）大泡性角膜病变患者施行DSAEK手术。在3至7个月的随访期内观察视力、角膜透明度、植片位置、角膜厚度、曲率、散光及内皮细胞密度（ECD）。

结果

1例虹膜角膜内皮综合征患者植片未能植入前房，改行穿透性角膜移植术。8例患者手术成功。1例植片脱位在术后第1天得到处理。所有8枚植片均保持透明且视力提高。术后平均角膜厚度为（775±30）微米。平均角膜曲率为（44.19±2.28）D。平均角膜散光为（2.20±0.83）D。平均内皮细胞密度为（1439±296）个细胞/平方毫米。