Sng Chelvin Ca, Luengo Gimeno Federico, Mehta Jodhbir S, Htoon Hla Myint, Tan Donald T
Singapore Eye Research Institute and Singapore National Eye Center, Singapore.
Clin Ophthalmol. 2012;6:479-86. doi: 10.2147/OPTH.S28971. Epub 2012 Mar 23.
To evaluate the intraoperative changes in the donor lenticule, recipient cornea, and the reduction of interface fluid thickness during Descemet's stripping and automated endothelial keratoplasty with EndoGlide™ (Angiotech Pharmaceuticals Inc, Vancouver, Canada) donor insertion, using intraoperative spectral-domain optical coherence tomography.
Prospective observational case series of patients underwent Descemet's stripping and automated endothelial keratoplasty using the EndoGlide inserter. Spectral-domain optical coherence tomography (iVue; Optovue Inc, Fremont, CA) with a handheld probe was used to image the cornea and anterior chamber. Standardized software was used to measure interface fluid gap, host cornea, and donor lenticule thicknesses during the following surgical stages of Descemet's stripping and automated endothelial keratoplasty: (1) after donor insertion and immediately before full air tamponade; (2) after air tamponade and expression of fluid from venting incisions; (3) at 6 minutes of air tamponade; and (4) at 10 minutes of air tamponade.
Ten patients with a mean age of 74.9 ± 11.8 years were recruited. Spectral-domain optical coherence tomography measurements of the interface fluid gap after fluid was expressed through the venting incisions (P < 0.001), at 6 minutes of air tamponade (P < 0.001) and at 10 minutes of air tamponade (P < 0.001 and P = 0.001, respectively), were significantly decreased compared to the measurements immediately before air tamponade. Donor thickness increased significantly at 6 minutes of air tamponade (P = 0.004) but reduced by 10 minutes compared to immediately before air tamponade.
Significant intraoperative changes in the donor, recipient cornea, and interface fluid thickness occurred following endothelial keratoplasty donor insertion.
使用术中光谱域光学相干断层扫描技术，评估在Descemet膜剥离联合EndoGlide™（加拿大温哥华安格泰科制药公司）自动内皮角膜移植术中供体透镜、受体角膜的术中变化以及界面液厚度的减少情况。
对接受使用EndoGlide插入器进行Descemet膜剥离联合自动内皮角膜移植术的患者进行前瞻性观察病例系列研究。使用带有手持探头的光谱域光学相干断层扫描（iVue；美国加利福尼亚州弗里蒙特市Optovue公司）对角膜和前房进行成像。在Descemet膜剥离联合自动内皮角膜移植术的以下手术阶段，使用标准化软件测量界面液间隙、宿主角膜和供体透镜厚度：（1）供体植入后且即将进行全空气填塞前；（2）空气填塞后且从排气切口排出液体后；（3）空气填塞6分钟时；（4）空气填塞10分钟时。
招募了10名平均年龄为74.9±11.8岁的患者。与空气填塞前即刻的测量值相比，通过排气切口排出液体后（P<0.001）、空气填塞6分钟时（P<0.001）以及空气填塞10分钟时（分别为P<0.001和P = 0.001）的界面液间隙的光谱域光学相干断层扫描测量值显著降低。供体厚度在空气填塞6分钟时显著增加（P = 0.004），但与空气填塞前即刻相比，10分钟时有所减少。
内皮角膜移植术供体植入后，供体、受体角膜及界面液厚度发生了显著的术中变化。
