Devers Eye Institute, Portland, Oregon; Lions Eye Bank of Oregon Vision Research Laboratory, Portland, OR 97210, USA.
Ophthalmology. 2011 Oct;118(10):1944-9. doi: 10.1016/j.ophtha.2011.02.023. Epub 2011 Jun 8.
To determine if donor graft diameter has a relationship with postoperative central endothelial cell density (ECD) and survival in Descemet's stripping automated endothelial keratoplasty (DSAEK).
Retrospective, comparative analysis of an interventional case series.
Three hundred thirty-one eyes of 243 patients undergoing DSAEK surgery for Fuchs' endothelial dystrophy without a history of rejection or graft dislocation.
Descemet's stripping automated endothelial keratoplasty was performed in 331 eyes with Fuchs' dystrophy. After exclusion of confounding variables, postoperative ECD and percentage cell loss was compared for 8.0-mm grafts (n = 154) versus 8.5-mm grafts (n = 165) over a 2-year postoperative period.
Total central ECD and percentage of donor endothelial cell loss as measured by specular microscopy of central ECD.
Mean preoperative ECD was 2635 cells/mm(2) for 8.0-mm grafts and 2732 cells/mm(2) for 8.5-mm grafts (P = 0.003). Mean ECD (and percent cell loss from before surgery) was 2011 cells/mm(2) (22.9%) for 8.0-mm grafts and 2078 cells/mm(2) (23.5%) for 8.5-mm grafts at 6 months, 2009 cells/mm(2) (23.3%) and 2113 cells/mm(2) (23.1%) at 1 year, and 2060 cells/mm(2) (23.4%) and 2111 cells/mm(2) (24.3%) at 2 years (P>0.72 for percentage cell loss at all time points).
Descemet's stripping automated endothelial keratoplasty grafts with a diameter of 8.5 mm do not offer a clinical advantage over smaller 8.0-mm grafts for postoperative endothelial cell counts in the first 2 years after surgery.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.
确定供体移植物直径与 Descemet 撕囊自动角膜内皮移植术（DSAEK）术后中央角膜内皮细胞密度（ECD）和存活率是否存在关系。
回顾性、干预性病例系列比较分析。
243 例因 Fuchs 内皮营养不良行 DSAEK 手术的患者 331 只眼，既往无排斥反应或移植物脱位史。
对 331 只患有 Fuchs 营养不良的眼睛进行 DSAEK 手术。排除混杂变量后，在术后 2 年的时间内，比较 8.0mm 移植物（n=154）与 8.5mm 移植物（n=165）的术后 ECD 和细胞丢失百分比。
中央 ECD 的总中央 ECD 和通过中央 ECD 共焦显微镜测量的供体内皮细胞丢失百分比。
8.0mm 移植物的平均术前 ECD 为 2635 个细胞/mm²，8.5mm 移植物为 2732 个细胞/mm²（P=0.003）。8.0mm 移植物的平均 ECD（以及从术前开始的细胞丢失百分比）为术后 6 个月时的 2011 个细胞/mm²（22.9%）和 2078 个细胞/mm²（23.5%），术后 1 年时的 2009 个细胞/mm²（23.3%）和 2113 个细胞/mm²（23.1%），术后 2 年时的 2060 个细胞/mm²（23.4%）和 2111 个细胞/mm²（24.3%）（所有时间点的细胞丢失百分比均为 P>0.72）。
在术后 2 年内，直径 8.5mm 的 Descemet 撕囊自动角膜内皮移植术移植物在术后内皮细胞计数方面并不优于直径 8.0mm 的较小移植物。
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