Department of Ophthalmology, Tel Aviv Sourasky Medical Center; and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Can J Ophthalmol. 2013 Jun;48(3):179-85. doi: 10.1016/j.jcjo.2013.01.003.
To compare the intraocular pressure (IOP) during the first postoperative year after penetrating keratoplasty (PK) and Descemet's stripping automated endothelial keratoplasty (DSAEK).
Retrospective chart review.
Fifty-three pseudophakic eyes of 53 patients who underwent PK or DSAEK because of endothelial dysfunction between January 2006 and December 2010 were included.
Surgeries consisted of 19 (35.8%) PK procedures and 34 (64.2%) DSAEK procedures. Demographic, preoperative, and postoperative data including IOP, number of medications, rejection and occurrence, and complications were recorded.
Patients who had undergone DSAEK had statistically significant lower IOP throughout 12 months after surgery than those who had undergone PK (p = 0.028), despite similar use of IOP-lowering medications during this time. Measurements of postoperative IOP greater than 21 mm Hg and greater than 30 mm Hg were significantly more common in patients who had undergone PK than DSAEK (p = 0.015 and 0.022, respectively). Complication rates were similar between the 2 groups. IOP was not correlated with patient age, sex, background illnesses, or previous glaucoma.
IOP is significantly lower after DSAEK compared with PK. Several mechanisms explaining this difference are proposed. New corneal transplantation modalities such as DSAEK, with a better postoperative IOP control, may reduce the risk for later visual loss caused by postoperative glaucomatous damage.
比较穿透性角膜移植术（PK）和撕囊自动化内皮角膜移植术（DSAEK）后第一年的眼内压（IOP）。
回顾性图表分析。
2006 年 1 月至 2010 年 12 月，因内皮功能障碍行 PK 或 DSAEK 的 53 例 53 只患眼纳入本研究。
手术包括 19 例（35.8%）PK 手术和 34 例（64.2%）DSAEK 手术。记录人口统计学、术前和术后数据，包括 IOP、药物使用数量、排斥反应和发生情况以及并发症。
尽管在此期间使用了相似的降眼压药物，但行 DSAEK 手术的患者术后 12 个月的 IOP 明显低于行 PK 手术的患者（p=0.028）。术后 IOP 大于 21mmHg 和大于 30mmHg 的测量值在接受 PK 手术的患者中明显多于 DSAEK 手术的患者（p=0.015 和 0.022）。两组患者的并发症发生率相似。IOP 与患者年龄、性别、基础疾病或既往青光眼无关。
与 PK 相比，DSAEK 术后 IOP 明显较低。提出了几种解释这种差异的机制。新的角膜移植方式，如 DSAEK，术后 IOP 控制更好，可能会降低术后青光眼损伤引起的视力丧失风险。
