Schrittenlocher Silvia, Penier Marius, Schaub Friederike, Bock Felix, Cursiefen Claus, Bachmann Björn
Department of Ophthalmology, University of Cologne, Cologne, Germany.
Department of Ophthalmology, University of Cologne, Cologne, Germany.
Am J Ophthalmol. 2017 Jul;179:129-136. doi: 10.1016/j.ajo.2017.04.024. Epub 2017 May 5.
To identify incidence of and risk factors for calcifications of intraocular lenses (IOLs) after Descemet membrane endothelial keratoplasty (DMEK).
Retrospective cohort study.
Retrospective review of charts and slit-lamp images of 564 consecutive patients from the prospective Cologne DMEK database who underwent DMEK in pseudophakic eyes or DMEK in combination with cataract surgery (triple-DMEK) between September 3, 2013 and October 30, 2015 at the Department of Ophthalmology, University of Cologne.
IOL calcifications after (triple-)DMEK occurred in 14 patients (2.5%). Visual acuities in affected and unaffected eyes were 0.33 ± 0.24 logMAR and 0.16 ± 0.01 logMAR after 3 months (P < .001) as well as 0.28 ± 0.16 logMAR and 0.13 ± 0.08 logMAR (P < .001) after 6 months, respectively. The proportions of triple-DMEK vs DMEK, the use of SF6 gas vs room air for anterior chamber tamponade, and the presence of hydrophilic vs hydrophobic acrylic IOLs were comparable in affected and unaffected eyes. Patients with IOL calcifications had higher rebubbling rates than patients without. Larger pupil diameters at the time of surgery showed a tendency to slightly larger areas of IOL calcifications.
IOL calcifications after anterior chamber gas tamponade in DMEK lead to visual impairment and are associated with the number of rebubblings after DMEK. IOL calcifications also occur in hydrophobic acrylic IOLs.
确定Descemet膜内皮角膜移植术(DMEK)后人工晶状体(IOL)钙化的发生率及危险因素。
回顾性队列研究。
对2013年9月3日至2015年10月30日在科隆大学眼科接受DMEK手术的564例连续性患者的病历和裂隙灯图像进行回顾性分析,这些患者均为人工晶状体眼接受DMEK手术或DMEK联合白内障手术(三联DMEK)。
(三联)DMEK术后IOL钙化发生在14例患者中(2.5%)。术后3个月,患眼和未患眼的视力分别为0.33±0.24 logMAR和0.16±0.01 logMAR(P<0.001),术后6个月分别为0.28±0.16 logMAR和0.13±0.08 logMAR(P<0.001)。患眼和未患眼在三联DMEK与DMEK的比例、前房填塞使用SF6气体与空气、亲水与疏水丙烯酸IOL的使用方面具有可比性。IOL钙化患者的再次注气率高于无钙化患者。手术时较大的瞳孔直径显示IOL钙化区域有稍大的趋势。
DMEK术中前房气体填塞后IOL钙化导致视力损害,并与DMEK术后再次注气次数有关。疏水丙烯酸IOL也会发生钙化。