Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India; Centre for Eye Research Australia, University of Melbourne, Melbourne, Victoria, Australia.
Clin Exp Ophthalmol. 2014 Jul;42(5):411-6. doi: 10.1111/ceo.12271. Epub 2013 Dec 9.
To evaluate the outcomes of single pass thin lenticule sutureless Descemet's stripping automated endothelial keratoplasty with donor lenticules prepared using a 400 μm microkeratome head.
Interventional case series.
Cases with corneal endothelial dysfunction.
Fifteen cases with corneal endothelial dysfunction (eight pseudophakic bullous keratopathy, three Fuchs' endothelial dystrophy, three congenital hereditary endothelial dystrophy and one failed graft) underwent thin lenticule Descemet's stripping automated endothelial keratoplasty at a tertiary care hospital. Donor lenticule was prepared with a single pass 400 μm Carriazo Barraquer microkeratome (Moria, Antony, France) head. Sutureless Descemet's stripping automated endothelial keratoplasty was performed in all the cases through a 3.5 mm corneoscleral tunnel using a Busin glide for graft insertion.
Main parameters evaluated were postoperative donor lenticule thickness and best-corrected visual acuity.
Donor lenticules were harvested successfully for all 15 cases without any complications. At 6-months follow up, the mean logMAR best-corrected visual acuity improved from 1.87 ± 0.52 to 0.109 ± 0.11 (P = < 0.0001). The mean donor lenticule thickness was 111 ± 17.62 μm (range 70-134 μm) at the last follow up. The mean endothelial cell loss was 26.33 ± 1.34%.
Thin donor lenticules for Descemet's stripping automated endothelial keratoplasty can be safely harvested using a single pass technique with 400 μm microkeratome head and can be used for a successful Descemet's stripping automated endothelial keratoplasty surgery.
评估使用 400μm 微角膜刀头制备的供体薄透镜无缝 Descemet 撕囊自动角膜内皮移植术治疗角膜内皮功能障碍的结果。
介入性病例系列。
角膜内皮功能障碍患者。
在一家三级护理医院，15 例角膜内皮功能障碍患者（8 例假性囊泡性大疱性角膜病变、3 例 Fuchs 内皮营养不良、3 例先天性遗传性内皮营养不良和 1 例移植失败）接受了薄透镜 Descemet 撕囊自动角膜内皮移植术。使用 Carriazo Barraquer 微角膜刀（Moria，Antony，France）头，通过单次通过 400μm 的方式制备供体薄透镜。在所有病例中，通过 3.5mm 的角巩膜隧道，使用 Busin 导板插入移植物，进行无缝 Descemet 撕囊自动角膜内皮移植术。
评估的主要参数是术后供体透镜的厚度和最佳矫正视力。
所有 15 例患者均成功收获供体透镜，无任何并发症。在 6 个月的随访中，平均 logMAR 最佳矫正视力从 1.87±0.52 提高到 0.109±0.11（P<0.0001）。最后一次随访时，平均供体透镜厚度为 111±17.62μm（范围 70-134μm）。平均内皮细胞丢失率为 26.33±1.34%。
使用 400μm 微角膜刀头进行单次通过技术可以安全地收获用于 Descemet 撕囊自动角膜内皮移植术的薄供体透镜，并可用于成功的 Descemet 撕囊自动角膜内皮移植术。
