短眼轴长度和虹膜损伤与亚洲人眼后弹力层内皮角膜移植术后虹膜后粘连相关。

Short Axial Length and Iris Damage Are Associated With Iris Posterior Synechiae After Descemet Membrane Endothelial Keratoplasty in Asian Eyes.

作者信息

Shimizu Toshiki, Hayashi Takahiko, Yuda Kentaro, Takahashi Hidenori, Oyakawa Itaru, Yamazaki Kenichiro, Mizuki Nobuhisa, Kato Naoko

机构信息

Department of Ophthalmology, Yokohama Minami Kyosai Hospital, Kanagawa, Japan.

Department of Ophthalmology, Yokohama City University School of Medicine, Yokohama, Japan.

出版信息

Cornea. 2018 Nov;37(11):1355-1359. doi: 10.1097/ICO.0000000000001698.

DOI:10.1097/ICO.0000000000001698

PMID:30004959

Abstract

PURPOSE

To evaluate the frequency and severity of iris posterior synechiae after Descemet membrane endothelial keratoplasty (DMEK) and to investigate possible causes of iris posterior synechiae.

METHODS

Twenty-three eyes were investigated in 20 Asian patients who underwent DMEK 1 month after phacoemulsification and intraocular lens implantation surgery. A preexisting iris damage score was defined by iris damage and classified into 5 grades. Six months after DMEK, the iris posterior synechiae severity score was evaluated based on the extent of posterior synechiae, according to every 45 degrees of the pupillary rim (posterior synechiae score, 0-8). Correlations were analyzed between the posterior synechiae score and preexisting factors (preexisting iris damage score, axial length [AXL], anterior chamber depth, and anterior chamber volume, both before and after cataract surgery).

RESULTS

Iris posterior synechiae appeared in 20 of 23 eyes (87.0%). Best spectacle-corrected visual acuity significantly improved at 6 months after DMEK (P < 0.001). Endothelial cell density was 1596 ± 530 cells/mm (P < 0.001); loss of cell density was 37.8 ± 19.9% at 6 months. Single regression analysis showed that the onset of iris posterior synechiae was correlated with the preexisting iris damage score (P = 0.006, r = 0.55), AXL (P < 0.001, r = -0.71), anterior chamber depth (P < 0.001, r = -0.70), and anterior chamber volume before cataract surgery (P < 0.001, r = -0.79).

CONCLUSIONS

Iris posterior synechiae after DMEK frequently appeared in Asian eyes with shorter AXLs or a damaged iris.

摘要

目的

评估Descemet膜内皮角膜移植术（DMEK）后虹膜后粘连的发生率和严重程度，并探究虹膜后粘连的可能原因。

方法

对20例亚洲患者的23只眼睛进行研究，这些患者在白内障超声乳化吸除联合人工晶状体植入术后1个月接受了DMEK。根据虹膜损伤情况定义既往虹膜损伤评分，并分为5个等级。DMEK术后6个月，根据瞳孔缘每45度的后粘连范围评估虹膜后粘连严重程度评分（后粘连评分，0 - 8分）。分析后粘连评分与既往因素（既往虹膜损伤评分、眼轴长度[AXL]、前房深度和白内障手术前后的前房容积）之间的相关性。

结果

23只眼中有20只（87.0%）出现虹膜后粘连。DMEK术后6个月最佳矫正视力显著提高（P < 0.001）。内皮细胞密度为1596 ± 530个/mm²（P < 0.001）；6个月时细胞密度损失为37.8 ± 19.9%。单因素回归分析显示，虹膜后粘连的发生与既往虹膜损伤评分（P = 0.006，r = 0.55）、AXL（P < 0.001，r = -0.71）、前房深度（P < 0.001，r = -0.70）以及白内障手术前的前房容积（P < 0.001，r = -0.79）相关。