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南亚人群中的Descemet膜内皮角膜移植术

Descemet's Membrane Endothelial Keratoplasty in South Asian Population.

作者信息

Bhandari Vipul, Reddy Jagdeesh K, Chougale Prateek

机构信息

Department of Cornea, Sankara Eye Centre, Coimbatore, Tamil Nadu, India.

出版信息

J Ophthalmic Vis Res. 2016 Oct-Dec;11(4):368-371. doi: 10.4103/2008-322X.194072.

Abstract

PURPOSE

To evaluate visual outcomes, endothelial cell density and complications following Descemet's membrane endothelial keratoplasty (DMEK).

METHODS

This study included 40 consecutive eyes that underwent DMEK for various pathologies involving the corneal endothelium. Best corrected visual acuity (BCVA) and endothelial cell density (ECD) were measured and compared before and 6 months after surgery.

RESULTS

Out of 40 eyes, 34 eyes (85%) had BCVA ranging from 0.5 to 0.7 LogMAR 6 months postoperatively. Mean donor ECD was 2367.96 ± 47.87 (range, 2314.0-2472.0) cells/mm preoperatively, which was reduced to 1798.42 ± 45.79 (range, 1736.0-1902.0) cells/mm 6 months after DMEK surgery, indicating a mean reduction of 569.54 cells/mm (24%) in ECD.

CONCLUSION

DMEK is an emerging and a more advanced alternative to penetrating keratoplasty (PKP) and Descemet's stripping endothelial keratoplasty (DSEK) for corneal pathologies involving the corneal endothelium. Compared to PK and DSEK, however, DMEK has a longer learning curve, and its safety and efficacy need to be confirmed through more experience on a large volume of cases.

摘要

目的

评估Descemet膜内皮角膜移植术(DMEK)后的视觉效果、内皮细胞密度及并发症。

方法

本研究纳入40例因各种累及角膜内皮的病变而接受DMEK手术的连续病例。测量并比较术前及术后6个月的最佳矫正视力(BCVA)和内皮细胞密度(ECD)。

结果

40眼中,34眼(85%)术后6个月的BCVA在0.5至0.7 LogMAR之间。术前供体ECD平均为2367.96±47.87(范围2314.0 - 2472.0)个细胞/mm²,DMEK手术后6个月降至1798.42±45.79(范围1736.0 - 1902.0)个细胞/mm²,表明ECD平均减少569.54个细胞/mm²(24%)。

结论

对于累及角膜内皮的角膜病变,DMEK是穿透性角膜移植术(PKP)和Descemet膜剥脱内皮角膜移植术(DSEK)的一种新兴且更先进的替代方法。然而,与PK和DSEK相比,DMEK的学习曲线更长,其安全性和有效性需要通过更多大量病例的经验来证实。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0e3/5139548/7b2b5352bde4/JOVR-11-368-g001.jpg

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