Mohamed Ashik, Ks Anil Raj, Chaurasia Sunita, Ramappa Muralidhar
Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India.
Cornea and Anterior Segment Services, L V Prasad Eye Institute, Hyderabad, India.
Br J Ophthalmol. 2016 Jun;100(6):754-6. doi: 10.1136/bjophthalmol-2015-306979. Epub 2015 Oct 29.
To evaluate and compare outcomes of Descemet's stripping endothelial keratoplasty (DSEK) with non-DSEK (nDSEK) in pseudophakic corneal oedema (PCE).
The study was a prospective, non-consecutive, comparative, interventional case series. Twenty-six patients with PCE were randomised into two groups. Group 1 comprised of those cases that had undergone conventional DSEK, and group 2 consisted of those that had nDSEK for PCE between 2010 and 2012. The data on demographics and clinical characteristics were collected from all patients. Any intraoperative and early and late postoperative complications were also noted. The primary outcome measure was postoperative functional success. Graft survival and complications were analysed as secondary outcomes.
The median best-corrected visual acuities at 6 months postoperatively in groups 1 and 2 were 0.18 (IQR 0.10-0.30) and 0.44 (IQR 0.18-0.51), respectively (p=0.11). Corneal oedema cleared in all patients. During the early postoperative period, a patient in group 2 had lenticule detachment managed by rebubbling.
nDSEK has outcomes similar to DSEK in PCE with advantages of decreased surgical time and avoidance of inadvertent pull on the posterior stromal fibres that may occur during Descemet's stripping.
评估并比较在人工晶状体眼角膜水肿（PCE）中，后弹力层剥除内皮角膜移植术（DSEK）与非DSEK（nDSEK）的治疗效果。
本研究为前瞻性、非连续性、对比性、干预性病例系列研究。26例PCE患者被随机分为两组。第1组包括接受传统DSEK的病例，第2组包括2010年至2012年间因PCE接受nDSEK的病例。收集所有患者的人口统计学和临床特征数据。还记录了所有术中及术后早期和晚期并发症。主要结局指标为术后功能成功。将移植物存活情况和并发症作为次要结局进行分析。
第1组和第2组术后6个月时的最佳矫正视力中位数分别为0.18（四分位间距0.10 - 0.30）和0.44（四分位间距0.18 - 0.51）（p = 0.11）。所有患者的角膜水肿均消退。术后早期，第2组有1例患者的晶状体微透镜脱离，通过再次注气处理。
在PCE中，nDSEK的治疗效果与DSEK相似，具有手术时间缩短以及避免在剥除后弹力层过程中可能出现的对后基质纤维意外牵拉的优点。
