Wu Hu-Ping, Dong Nuo, Xie Su-Zhen, Li Cheng, Li Xue-Zhi, Liu Zhao-Sheng
Ocular Surface and Corneal Disease Department, the Affiliated Xiamen Eye Center of Xiamen University, Xiamen 361001, China.
Zhonghua Yan Ke Za Zhi. 2011 May;47(5):410-5.
To investigate the feasibility and clinical effects of non-Descemet stripping endothelial keratoplasty (nDSEK) on treating iridocorneal endothelial (ICE) syndrome in phakic eyes.
Retrospective noncomparative interventional case series. 7 patients (7 eyes) with ICE syndrome at the Affiliated Xiamen Eye Center of Xiamen University from January 2008 to December 2009 underwent non-Descemet stripping endothelial keratoplasty. All patients were followed up for 3 - 12 months, pre- and postoperative best corrected visual acuity (BCVA) were compared, the adherence of the donor disc to the recipient endothelium and postoperative donor disc dislocation were monitored during the follow-up period. Graft clearance and endothelial cell density (ECD) were observed, too.
After nDSEK, no primary graft failures dislocation and decentered graft occurred during the follow-up period. Study group intraoperative complications included 3 case with elevated intraocular pressure 2 day postoperatively. Subepithelial haze, donor-recipient interface haze, and interface particles were observed in all measurable cases by in vivo laser confocal microscopy. Anterior segment optical coherence tomography and ultrasound biomicroscopy showed the adherence of the donor disc to the recipient endothelium and peripheral anterior synechiae were separated. All corneas remained clear during the follow-up. 6 patients had improved BCVA while 1 patient had the same BCVA. The reason for poor VA was optic atrophy due to glaucoma. Postoperative mean EDC was (2176.6 ± 267.6) cells/mm(2).
nDSEK for iridocorneal endothelial (ICE) syndrome is feasible, technically easy, safe and effective. It can be one of the surgical treatment option for bullous keratopathy.
探讨非穿透性深板层内皮角膜移植术（nDSEK）治疗有晶状体眼虹膜角膜内皮（ICE）综合征的可行性及临床效果。
回顾性非对照干预性病例系列研究。2008年1月至2009年12月在厦门大学附属厦门眼科中心，7例（7眼）ICE综合征患者接受了非穿透性深板层内皮角膜移植术。所有患者随访3 - 12个月，比较术前和术后最佳矫正视力（BCVA），随访期间监测供体植片与受体内皮的贴合情况及术后供体植片脱位情况。同时观察植片清除情况及内皮细胞密度（ECD）。
nDSEK术后随访期间未发生原发性植片失败、脱位及植片偏心。研究组术中并发症包括3例术后2天眼压升高。所有可测量病例通过活体激光共聚焦显微镜观察到上皮下混浊、供体 - 受体界面混浊及界面颗粒。眼前节光学相干断层扫描和超声生物显微镜检查显示供体植片与受体内皮贴合，周边前粘连分离。随访期间所有角膜保持透明。6例患者BCVA提高，1例患者BCVA无变化。视力差的原因是青光眼导致的视神经萎缩。术后平均ECD为（2176.6 ± 267.6）个细胞/mm²。
nDSEK治疗虹膜角膜内皮（ICE）综合征可行，技术操作简便，安全有效。它可作为大泡性角膜病变的手术治疗选择之一。
