Department of Ophthalmology, Tokyo Dental College Ichikawa General Hospital, Ichikawa, 5-11-13 Sugano Ichikawa, Chiba, Japan.
Cornea. 2013 Sep;32(9):1255-9. doi: 10.1097/ICO.0b013e318299c3b7.
To study the ocular surface changes in eyes after Descemet stripping automated endothelial keratoplasty (DSAEK) compared with those after penetrating keratoplasty (PKP).
This prospective study compared the changes in 31 eyes of 28 patients who underwent DSAEK (DSAEK group) with those in 15 disease-matched eyes of 15 patients who underwent PKP (PKP group). Corneal epithelial integrity was evaluated using a fluorescein staining score. Corneal sensation was measured with a Cochet-Bonnet esthesiometer. Tear function was evaluated using the Schirmer test, tear clearance test, tear function index, and tear break-up time.
The postoperative fluorescein staining score was significantly higher in the PKP group than in the DSAEK group (P = 0.02). Postoperative corneal sensation was significantly better in the DSAEK group than in the PKP group (P < 0.01). Corneal sensation after DSAEK was significantly better than the preoperative value (P = 0.02). There were no statistically significant changes in the Schirmer test, tear clearance test, tear function index, or break-up time before and after the surgery in both the DSAEK and PKP groups. No significant differences were observed between the DSAEK and PKP groups after the surgery.
Corneal sensation was preserved, and epithelial damage was less severe after DSAEK compared with PKP. Preservation of corneal sensation may contribute to the early recovery of visual function and long-term maintenance of ocular surface health after DSAEK.
研究与穿透性角膜移植术（PKP）相比，后弹力层内皮角膜切除术（DSAEK）后眼睛的眼表变化。
这项前瞻性研究比较了 28 例 31 只眼接受 DSAEK（DSAEK 组）与 15 例 15 只眼接受 PKP（PKP 组）的患者的变化。使用荧光素染色评分评估角膜上皮完整性。使用 Cochet-Bonnet 触觉计测量角膜感觉。使用 Schirmer 测试、泪液清除测试、泪液功能指数和泪膜破裂时间评估泪液功能。
PKP 组术后荧光素染色评分明显高于 DSAEK 组（P = 0.02）。DSAEK 组术后角膜感觉明显优于 PKP 组（P < 0.01）。DSAEK 术后角膜感觉明显优于术前（P = 0.02）。DSAEK 和 PKP 组手术前后 Schirmer 测试、泪液清除测试、泪液功能指数和泪膜破裂时间均无统计学差异。手术前后 DSAEK 和 PKP 组之间无显著差异。
与 PKP 相比，DSAEK 后角膜感觉得到保留，上皮损伤较轻。角膜感觉的保留可能有助于 DSAEK 后视觉功能的早期恢复和眼表健康的长期维持。
