Augustin Victor A, Weller Julia M, Kruse Friedrich E, Tourtas Theofilos
Department of Ophthalmology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany.
Eur J Ophthalmol. 2019 Mar;29(2):165-170. doi: 10.1177/1120672118785282. Epub 2018 Jul 11.
: To analyze and correlate corneal parameters with refractive shift after Descemet membrane endothelial keratoplasty combined with cataract surgery (triple Descemet membrane endothelial keratoplasty).
: This single-center retrospective observational case series included 152 eyes of 152 consecutive patients undergoing triple Descemet membrane endothelial keratoplasty in the first eye for Fuchs endothelial corneal dystrophy. Patients were examined preoperatively, as well as at 3, 6, and 12 months after surgery. The main outcome measures were: refractive shift (predicted refractive outcome based on intraocular lens calculation compared to actual postoperative refractive outcome), central corneal thickness, corneal volume, anterior and posterior corneal curvature, and corneal densitometry. These parameters were analyzed and correlated with the refractive shift after surgery.
: After 3 months from surgery, a mean refractive shift of +1.12 ± 1.10 D was observed and remained stable until the last follow-up at 12 months (+1.24 ± 1.07 D). Correlation analysis showed a weak but significant positive correlation between refractive shift and preoperative posterior curvature (rho = 0.314; p = 0.002) or preoperative posterior densitometry (rho = 0.227; p = 0.008). No correlation was found between refractive shift and preoperative central corneal thickness, corneal volume, anterior curvature, or anterior/mid-cornea densitometry.
: Changes of the posterior cornea may have an influence on the refractive shift. Patients with flatter posterior corneal curvature or higher posterior corneal density seem to exhibit a higher hyperopic shift. The weak correlations indicate a poor predictive value of any preoperative parameter used in our study.
分析并关联Descemet膜内皮角膜移植联合白内障手术（三联Descemet膜内皮角膜移植术）后角膜参数与屈光变化。
本单中心回顾性观察病例系列纳入了152例因Fuchs内皮角膜营养不良而首次接受一眼三联Descemet膜内皮角膜移植术的连续患者的152只眼。患者在术前以及术后3、6和12个月接受检查。主要观察指标包括：屈光变化（基于人工晶状体计算的预测屈光结果与实际术后屈光结果相比）、中央角膜厚度、角膜体积、角膜前后曲率以及角膜密度测定。对这些参数进行分析并与术后屈光变化相关联。
术后3个月时，观察到平均屈光变化为+1.12±1.10 D，并一直稳定至12个月的最后一次随访（+1.24±1.07 D）。相关性分析显示，屈光变化与术前角膜后曲率（rho = 0.314；p = 0.002）或术前角膜后密度测定（rho = 0.227；p = 0.008）之间存在弱但显著的正相关。在屈光变化与术前中央角膜厚度、角膜体积、前曲率或角膜前/中密度测定之间未发现相关性。
角膜后部的变化可能对屈光变化有影响。角膜后曲率较平或角膜后密度较高的患者似乎表现出更高的远视性屈光变化。这种弱相关性表明我们研究中使用的任何术前参数的预测价值较差。
