Einan-Lifshitz Adi, Sorkin Nir, Boutin Tanguy, Showail Mahmood, Borovik Armand, Jamshidi Farzad, Chan Clara C, Rootman David S
Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Canada.
University of British Columbia, Vancouver, Canada.
Cornea. 2018 Mar;37(3):273-276. doi: 10.1097/ICO.0000000000001485.
To compare the efficacy and safety of 20% sulfur hexafluoride gas (SF6) and air tamponade in patients who underwent noniridectomized Descemet membrane endothelial keratoplasty (DMEK).
A retrospective chart review of patients who underwent DMEK with either air or SF6 tamponade: 41 eyes received air tamponade (group 1) and 41 received SF6 tamponade (group 2). Best spectacle-corrected visual acuity, endothelial cell density, and complications including graft detachment and elevated intraocular pressure were compared.
The mean follow-up time was 8 ± 4 months in group 1 and 3 ± 2 months in group 2. Mean best spectacle-corrected visual acuity improved from 1.12 ± 0.88 to 0.64 ± 0.78 logarithm of the minimum angle of resolution (logMAR) in group 1 (P = 0.009) and from 1.00 ± 0.78 to 0.62 ± 0.53 logMAR in group 2 (P = 0.006). The graft detachment rate was 39% (16 eyes) in group 1 and 42% (17 eyes) in group 2 (P = 0.822). The rate of graft detachment larger than one third of the graft area was 17% in group 1 and 20% in group 2 (P = 0.775). Rebubbling was performed in 26.8% and 20% of eyes in group 1 and 2, respectively (P = 0.43). Average endothelial cell loss was 32% in group 1 and 33% in group 2 (P = 0.83). In the immediate postoperative period, elevated intraocular pressure was observed in 2 eyes (5%) in group 1 and in 4 eyes (10%) in group 2 (P = 0.4). There was 1 primary graft failure in each group.
Use of air with it being readily available and short acting is a good method of Descemet membrane tamponade in noniridectomized DMEK.
比较20%六氟化硫气体（SF6）和空气填塞在未行虹膜切除术的Descemet膜内皮角膜移植术（DMEK）患者中的疗效和安全性。
对接受空气或SF6填塞的DMEK患者进行回顾性病历审查：41只眼接受空气填塞（第1组），41只眼接受SF6填塞（第2组）。比较最佳矫正视力、内皮细胞密度以及包括移植物脱离和眼压升高在内的并发症。
第1组平均随访时间为8±4个月，第2组为3±2个月。第1组最佳矫正视力平均从最小分辨角对数（logMAR）1.12±0.88提高到0.64±0.78（P = 0.009），第2组从1.00±0.78提高到0.62±0.53 logMAR（P = 0.006）。第1组移植物脱离率为39%（16只眼），第2组为42%（17只眼）（P = 0.822）。移植物脱离面积大于移植物面积三分之一的比例在第1组为17%，在第2组为20%（P = 0.775）。第1组和第2组分别有26.8%和20%的眼睛进行了再次注气（P = 0.43）。第1组平均内皮细胞损失为32%，第2组为33%（P = 0.83）。术后即刻，第1组有2只眼（5%）出现眼压升高，第2组有4只眼（10%）出现眼压升高（P = 0.4）。每组各有1例原发性移植物失败。
空气易于获取且作用时间短，在未行虹膜切除术的DMEK中是一种良好的Descemet膜填塞方法。
