Department of Ophthalmology, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka 420-2295, Japan.
Jpn J Ophthalmol. 2012 Sep;56(5):436-40. doi: 10.1007/s10384-012-0163-2. Epub 2012 Jul 7.
Our aim was to evaluate the surgical technique and postoperative results of Descemet stripping automated endothelial keratoplasty (DSAEK) for bullous keratopathy in eyes with microcornea.
Two patients with microcornea (8.8 mm in case 1 and 9.3 mm in case 2) and bullous keratopathy after cataract surgery or after laser iridotomy were treated by DSAEK. A donor lamella with a smaller diameter (7.5 mm) was inserted into the anterior chamber using the double-glide donor insertion technique (Busin glide with intraocular lens sheet glide).
No intraoperative or postoperative complications occurred. Corrected visual acuity improved from counting fingers to 0.222 logMAR in case 1 and from 1.000 to 0.155 logMAR in case 2 over 6 months. Corneal endothelial cell loss was 6.5 % in case 1 and 1.9 % in case 2.
DSAEK was useful for bullous keratopathy in patients with microcornea. However, surgery should be done with meticulous care, and modification of the diameter of the donor lamella and of the donor insertion technique may be required.
我们旨在评估用于小角膜合并大泡性角膜病变的撕囊联合内皮层角膜移植术（DSAEK）的手术技术和术后结果。
对 2 例小角膜（1 例为 8.8mm，2 例为 9.3mm）并在白内障手术后或激光虹膜切开术后出现大泡性角膜病变的患者进行 DSAEK 治疗。使用双滑行供体插入技术（Busin 滑行与眼内晶状体片滑行）将直径较小（7.5mm）的供体层插入前房。
2 例患者均未发生术中或术后并发症。在 6 个月时，1 例患者的矫正视力从指数提高到 0.222logMAR，2 例患者从 1.000 提高到 0.155logMAR。1 例患者角膜内皮细胞丢失 6.5%，2 例患者丢失 1.9%。
DSAEK 对小角膜合并大泡性角膜病变患者有效。但是，手术需要精心操作，可能需要修改供体层的直径和供体插入技术。
