Singapore National Eye Centre, Singapore, Singapore Singapore Eye Research Institute, Singapore, Singapore.
Singapore National Eye Centre, Singapore, Singapore.
Br J Ophthalmol. 2014 Aug;98(8):1028-32. doi: 10.1136/bjophthalmol-2013-304622. Epub 2014 Mar 27.
To describe outcomes and complications following Descemet's stripping automated endothelial keratoplasty (DSAEK) in eyes with pseudophakic bullous keratopathy (BK) while retaining the anterior chamber intraocular lenses (ACIOL).
We included consecutive patients who underwent DSAEK for BK at a single tertiary centre from 1 January 2008 to 1 April 2010, from our prospective cohort (Singapore Corneal Transplant Study). We compared eyes with BK, which underwent DSAEK while retaining ACIOL (n=18), to those with DSAEK alone with the posterior chamber intraocular lenses left in place as a comparison group (n=114). Main outcome measures were endothelial cell (EC) loss and graft survival.
The percentage EC loss at 1 year was 31.9±21.3% in the DSAEK with ACIOL group compared to 24.5±21.2% in the DSAEK group (p=0.516); however, this figure was significantly greater in the DSAEK with ACIOL group at 3 years compared to the DSAEK group (55.3±29.2% vs 33.3±20.8%; p=0.01 respectively). Graft survival was also significantly poorer in the DSAEK ACIOL group compared to the DSAEK group over 3 years (log rank p=0.002).
We found that although eyes with BK and ACIOL that underwent DSAEK while retaining the ACIOL suffered EC loss which was not significantly greater at 1 year, EC loss and graft survival were significantly poorer compared to DSAEK controls at 3 years postoperatively.
描述保留前房人工晶状体（ACIOL）的情况下，行去表皮的全自动角膜内皮移植术（DSAEK）治疗白内障术后大泡性角膜病变（BK）的结果和并发症。
我们纳入了 2008 年 1 月 1 日至 2010 年 4 月 1 日在单一眼科中心接受 DSAEK 治疗 BK 的连续患者，该研究来自我们的前瞻性队列（新加坡角膜移植研究）。我们比较了保留 ACIOL 行 DSAEK 的 BK 眼（n=18）和 DSAEK 眼（n=114），后者将后房人工晶状体留在原位作为对照组。主要观察指标为内皮细胞（EC）损失和移植物存活率。
保留 ACIOL 的 DSAEK 组 1 年时 EC 损失百分比为 31.9%±21.3%，而单纯 DSAEK 组为 24.5%±21.2%（p=0.516）；然而，保留 ACIOL 的 DSAEK 组在 3 年时明显高于单纯 DSAEK 组（55.3%±29.2%比 33.3%±20.8%；p 分别为 0.01）。保留 ACIOL 的 DSAEK 组在 3 年时的移植物存活率也明显低于单纯 DSAEK 组（log rank p=0.002）。
我们发现，尽管保留 ACIOL 的 BK 眼行 DSAEK 治疗后 EC 损失在 1 年时没有明显增加，但与单纯 DSAEK 对照组相比，3 年后 EC 损失和移植物存活率明显更差。
