PIONEER 研究中术中 OCT 上的瞬态界面液与 DSAEK 手术后的纹理状界面不透明之间的关联。
Association between transient interface fluid on intraoperative OCT and textural interface opacity after DSAEK surgery in the PIONEER study.
机构信息
Cole Eye Institute, Cleveland Clinic, Cleveland, OH.
出版信息
Cornea. 2014 Sep;33(9):887-92. doi: 10.1097/ICO.0000000000000209.
PURPOSE
The aim of this study was to examine the association between transient interface fluid (TIF) and textural interface opacity (TIO) after Descemet stripping automated endothelial keratoplasty (DSAEK) surgery using intraoperative optical coherence tomography (iOCT) in the PIONEER (Prospective Intraoperative and Perioperative Ophthalmic ImagiNg with Optical CoherEncE TomogRaphy) study.
METHODS
All consecutive eyes that underwent DSAEK between October 2011 and September 2013 from the PIONEER intraoperative and perioperative OCT study were included. iOCT images were captured after lenticule apposition with complete air fill and after air-fluid exchange. Postoperative day 1 OCT images were obtained. Outcome variables included the presence of TIO at the graft-host junction and the presence of intraoperative and postoperative interface fluid on OCT.
RESULTS
Seventy-six eyes from 69 patients who underwent DSAEK with iOCT were included. The mean age of the patients was 71 years (range 31-90). The 2 most common indications for surgery were Fuchs dystrophy (63%) and pseudophakic bullous keratopathy (24%). In 18 of 76 (23.7%) eyes, TIF was visible on iOCT post air-fluid exchange. Of these eyes, 14 developed TIO. TIO was observed in 18 of 76 (23.7%) eyes. TIF on iOCT was associated with a significantly higher rate of postoperative TIO (odds ratio = 47.25; P < 0.0001). Sixteen of the 18 eyes that had TIF on iOCT had had resolution on the postoperative day 1 OCT. There was no significant difference in the mean graft thickness between eyes with TIF on iOCT and those without (P = 0.58).
CONCLUSIONS
Eyes with TIF on iOCT are more likely to develop TIO in the postoperative period. It is believed that the process of gap closure results in TIO, possibly secondary to precipitated solutes, retained viscoelastic, or lamellar irregularities caused by delayed adhesion or uneven matching of lamellar fibrils.
目的
本研究旨在使用术中光相干断层扫描（iOCT）检查在 PIONEER（前瞻性术中及围手术期眼科成像与光学相干断层扫描）研究中经去表皮自动内皮角膜移植（DSAEK）手术后瞬态界面液（TIF）与界面纹理不透明度（TIO）之间的相关性。
方法
纳入 2011 年 10 月至 2013 年 9 月期间连续接受 DSAEK 的所有患者，这些患者均来自 PIONEER 术中及围手术期 OCT 研究。在完成空气填充后及进行空气-液交换后，采集 Lenticule 贴附的 iOCT 图像。术后第 1 天进行 OCT 检查。观察变量包括在移植物-宿主交界处存在 TIO 以及在 OCT 上观察到术中及术后界面液的存在。
结果
共纳入 76 只眼 69 例接受 DSAEK 并进行 iOCT 的患者。患者的平均年龄为 71 岁（范围 31-90）。最常见的两种手术指征为 Fuchs 营养不良（63%）和后发性白内障性大泡性角膜病变（24%）。在 76 只眼中，有 18 只（23.7%）在空气-液交换后 iOCT 上可见 TIF。这些眼睛中有 14 只出现 TIO。在 76 只眼中，有 18 只（23.7%）出现 TIO。iOCT 上的 TIF 与术后 TIO 的发生率显著相关（比值比=47.25；P<0.0001）。在 iOCT 上有 TIF 的 18 只眼中，有 16 只在术后第 1 天 OCT 上已经消退。在 iOCT 上有 TIF 的眼睛与没有 TIF 的眼睛之间平均移植物厚度无显著差异（P=0.58）。
结论
iOCT 上存在 TIF 的眼睛在术后更有可能出现 TIO。人们认为，间隙闭合的过程导致了 TIO，这可能是由于沉淀的溶质、残留的粘性物质、或由于延迟黏附或板层纤维不均匀匹配而导致的板层不规则引起的。
Zotero 插件