Reimer A, Langenbucher A, Cursiefen C
Zentrum für Augenheilkunde, Universität zu Köln, Köln.
Klin Monbl Augenheilkd. 2012 Feb;229(2):149-57. doi: 10.1055/s-0031-1281760. Epub 2011 Nov 17.
The aim of this study was to analyse the long-term functional results of penetrating keratoplasty for pseudophacic bullous keratopathy and Fuchs endothelial dystrophy and to analyse the potential influence of the preoperative visual acuity on the final outcome.
This retrospective study describes the postoperative results of 413 patients. 154 of them with bullous keratopathy and 259 patients with Fuchs dystrophy. All received penetrating excimer laser keratoplasty (PK).The results include the examination of the patients 1 / 3 / 5 / 8 / > 9 years postoperatively. For analysis the patients were divided in two groups: group I includes patients with a visual acuity ≤ 0.1 and group II with a visual acuity > 0.1. The trephination was performed using a 193 nm excimer laser. The transplanted cornea was fixed by using a double running cross-stitch suture. The outcome measures included best corrected visual acuity (CCV), keratometric equivalent (KEQ), keratometric astigmatism (AST), spherical equivalent (SEQ), refractive cylinder (CYL), best corrected visual acuity (BCVA), surface regularity index (SRI), surface asymmetry index (SAI), potential visual acuity (PVA), pachymetry (PAC), endothelial cell count (ECC), intraocular tension (TEN), topographic equivalent (T-EQ) and topographic astigmatism (T-AST).
5 / 8 years postoperatively CCV was 0.55 / 0.58; KEQ was 43.75 / 45.64 D; SEQ - 0.88 /- 1.88 D; AST was 3.91 / 4.41 D; CYL was 3.09 / 3.40 D; ECC was 1230 / 1080 cells/mm (2); TEN was 13.61 / 14.36 mmHg; PAC was 593.21 / 579.50 µm; SRI was 1.08 / 0.89; SAI was 1.31 / 1.10; PVA was 0.77 / 0.83; T-EQ was 44.78 / 44.92 D and T-AST was 4.85 / 3.92 D. The outcome of patients with a preoperative visual acuity of ≤ 0.1 was significantly worse than the group with the visual acuity of > 0.1.
This study shows that the long-term results after penetrating keratoplasty for pseudophacic bullous keratopathy and Fuchs endothelial dystrophy are good. Patients with preoperative visual acuity of ≤ 0.1 had worse final results.
本研究旨在分析穿透性角膜移植术治疗假性晶状体大泡性角膜病变和Fuchs内皮营养不良的长期功能结果，并分析术前视力对最终结果的潜在影响。
这项回顾性研究描述了413例患者的术后结果。其中154例患有大泡性角膜病变，259例患有Fuchs营养不良。所有患者均接受了准分子激光穿透性角膜移植术（PK）。结果包括术后1/3/5/8/＞9年对患者的检查。为进行分析，将患者分为两组：第一组包括视力≤0.1的患者，第二组包括视力＞0.1的患者。使用193nm准分子激光进行环钻术。移植的角膜通过双连续十字缝合法固定。结果指标包括最佳矫正视力（CCV）、角膜曲率当量（KEQ）、角膜散光（AST）、等效球镜度（SEQ）、屈光柱镜度（CYL）、最佳矫正视力（BCVA）、表面规则性指数（SRI）、表面不对称指数（SAI）、潜在视力（PVA）、角膜厚度测量（PAC）、内皮细胞计数（ECC）、眼压（TEN）、地形等效值（T-EQ）和地形散光（T-AST）。
术后5/8年，CCV分别为0.55/0.58；KEQ分别为43.75/45.64D；SEQ分别为-0.88/-1.88D；AST分别为3.91/4.41D；CYL分别为3.09/3.40D；ECC分别为1230/1080个细胞/mm²；TEN分别为13.61/14.36mmHg；PAC分别为593.21/579.50µm；SRI分别为1.08/0.89；SAI分别为1.31/1.10；PVA分别为0.77/0.83；T-EQ分别为44.78/44.92D；T-AST分别为4.85/3.92D。术前视力≤0.1的患者的结果明显比视力＞0.1的组差。
本研究表明，穿透性角膜移植术治疗假性晶状体大泡性角膜病变和Fuchs内皮营养不良的长期结果良好。术前视力≤0.1的患者最终结果较差。
