Nieuwendaal Carla P, van der Meulen Ivanka J E, Lapid-Gortzak Ruth, Mourits Maarten P
Department of Ophthalmology, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Int Ophthalmol. 2013 Apr;33(2):147-51. doi: 10.1007/s10792-012-9665-7. Epub 2012 Nov 6.
To assess the incidence of elevated intraocular pressure (IOP) after descemet stripping endothelial keratoplasty (DSEK). Retrospective case series. From the start of the technique in our hospital in 2003 until the middle of 2010, 73 eyes underwent DSEK, of which 66 (90.5 %) had a clear graft 1 year after surgery. IOP data pre- and postoperatively were analyzed. Follow-up was 1-5 years (mean 3.8, SD 1.3). Mean age was 71 years (SD 11, range 43-89). Three eyes (4.5 %) had a history of glaucoma before DSEK. Mean pre-operative IOP was 12.4 mmHg (SD ± 4.3). Mean IOP 1 day post-operatively was 16.4 mmHg (±9.2). Mean IOP after 1 and 6 months, and 1, 3, and 5 years were, respectively, 13.9 (±5.3), 14.7 (±5.6), 14.2 (±5.4), 13.8 (±3.7), and 12.6 (±3.5). Seventeen percent (11 eyes) had a postoperative rise in IOP which needed medical or surgical intervention: 8 % (5 eyes) had a rise in IOP 1 day after DSEK, of which 1 underwent a trabeculectomy 7 months after DSEK surgery; 6 % (4 eyes) had a rise in IOP later in the postoperative period, which could all be managed medically; and 3 % (2 eyes) had increased IOP 1 day after DSEK and later in the postoperative period, both eyes underwent a trabeculectomy 5 and 24 months, respectively, after DSEK surgery. An increase in IOP was encountered in 17 % of DSEK patients. Checking the IOP in the short and long postoperative period is necessary.
评估角膜后弹力层剥除内皮角膜移植术（DSEK）后眼压升高的发生率。回顾性病例系列研究。自2003年我院开展该技术起至2010年年中，73只眼接受了DSEK手术，其中66只眼（90.5%）术后1年植片透明。对术前和术后的眼压数据进行分析。随访时间为1至5年（平均3.8年，标准差1.3年）。平均年龄为71岁（标准差11岁，范围43至89岁）。3只眼（4.5%）在DSEK手术前有青光眼病史。术前平均眼压为12.4 mmHg（标准差±4.3）。术后1天平均眼压为16.4 mmHg（±9.2）。术后1个月、6个月以及1年、3年和5年的平均眼压分别为13.9（±5.3）、14.7（±5.6）、14.2（±5.4）、13.8（±3.7）和12.6（±3.5）。17%（11只眼）的患者术后眼压升高，需要药物或手术干预：8%（5只眼）在DSEK术后1天眼压升高，其中1只眼在DSEK手术后7个月接受了小梁切除术；6%（4只眼）在术后较晚时间眼压升高，均通过药物治疗；3%（2只眼）在DSEK术后1天及术后较晚时间眼压升高，两只眼分别在DSEK手术后5个月和24个月接受了小梁切除术。17%的DSEK患者出现眼压升高。术后短期和长期监测眼压是必要的。
