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在角膜后弹力层剥除自动内皮角膜移植术中使用EndoGlide与EndoSerter植入供体植片的比较

EndoGlide versus EndoSerter for the insertion of donor graft in descemet stripping automated endothelial keratoplasty.

作者信息

Elbaz Uri, Yeung Sonia N, Lichtinger Alejandro, Zauberman Noa Avni, Goldich Yakov, Ziai Setareh, Chan Clara C, Rootman David S, Slomovic Allan R

机构信息

Department of Ophthalmology and Vision Sciences, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada.

Department of Ophthalmology and Vision Sciences, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada.

出版信息

Am J Ophthalmol. 2014 Aug;158(2):257-262.e1. doi: 10.1016/j.ajo.2014.05.012. Epub 2014 May 20.

Abstract

PURPOSE

To compare 2 lenticule insertion methods currently in use for Descemet stripping automated endothelial keratoplasty (DSAEK).

DESIGN

Prospective randomized single-masked study.

PATIENTS AND METHODS

Twenty patients with Fuchs endothelial dystrophy and pseudophakic bullous keratopathy undergoing DSAEK surgery were included and randomized to the use of either EndoGlide or EndoSerter as a delivery method for the donor lenticule. Post surgery, patients were monitored for up to 1 year. Evaluation included corrected distance visual acuity (CDVA) and refraction. Specular microscopy images were obtained at the 6- and 12-month visits. Complications, including rebubbling rate, graft dislocation, and graft failure, were recorded.

RESULTS

Twenty eyes were randomized to receive the Tan EndoGlide or the EndoSerter injector for lenticule insertion. Mean patient age was 65.9±8.4 years and 70.3±9.8 years in the Tan EndoGlide and EndoSerter groups, respectively (P=.3). Two eyes in each group needed rebubbling. The mean endothelial cell loss, including the rebubbled eyes, at the 12-month visit was 1093±629 cells/mm2 (range: 239-2109 cells/mm2, mean percentage cell loss 41.2%) and 877±566 cells/mm2 (range: 116-1851 cells/mm2, mean percentage cell loss 31.4%) in the Tan EndoGlide and EndoSerter groups, respectively (P=.45). Mean CDVA did not show a statistically significant difference between the 2 groups at the 6- or 12-month visit.

CONCLUSION

The EndoSerter shows comparable results to the Tan EndoGlide. However, further investigation is warranted in order to validate these findings.

摘要

目的

比较目前用于Descemet膜剥离自动内皮角膜移植术(DSAEK)的两种晶状体植入方法。

设计

前瞻性随机单盲研究。

患者和方法

纳入20例行DSAEK手术的Fuchs内皮营养不良和假晶状体大疱性角膜病变患者,随机分为使用EndoGlide或EndoSerter作为供体晶状体植入方法的两组。术后对患者进行长达1年的监测。评估包括矫正远视力(CDVA)和屈光。在术后6个月和12个月的随访中获取镜面显微镜图像。记录并发症,包括再气泡形成率、移植物脱位和移植物失败。

结果

20只眼被随机分配接受Tan EndoGlide或EndoSerter注射器进行晶状体植入。Tan EndoGlide组和EndoSerter组患者的平均年龄分别为65.9±8.4岁和70.3±9.8岁(P = 0.3)。每组各有2只眼需要再气泡形成。在术后12个月的随访中,包括再气泡形成的眼在内,Tan EndoGlide组和EndoSerter组的平均内皮细胞损失分别为1093±629个细胞/mm²(范围:239 - 2109个细胞/mm²,平均细胞损失百分比41.2%)和877±566个细胞/mm²(范围:116 - 1851个细胞/mm²),平均细胞损失百分比31.4%(P = 0.45)。在术后6个月或12个月的随访中,两组的平均CDVA无统计学显著差异。

结论

EndoSerter与Tan EndoGlide显示出相当的结果。然而,为了验证这些发现,有必要进行进一步的研究。

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