Kurji Khaliq H, Cheung Albert Y, Eslani Medi, Rolfes Erin J, Chachare Deepali Y, Auteri Nicholas J, Nordlund Michael L, Holland Edward J
Cincinnati Eye Institute, Cincinnati, OH.
Department of Ophthalmology, University of Cincinnati, Cincinnati, OH.
Cornea. 2018 Oct;37(10):1226-1231. doi: 10.1097/ICO.0000000000001697.
To compare the visual outcomes and complications between nanothin Descemet stripping automated endothelial keratoplasty (NT-DSAEK) and Descemet membrane endothelial keratoplasty (DMEK).
A prospective comparative case series of 28 consecutive cases of NT-DSAEK (less than or equal to 50 μm) and DMEK was undertaken. Inclusion criteria were a diagnosis of Fuchs dystrophy, presence of pseudophakia, or planned combined cataract surgery/endothelial keratoplasty, with a minimum of 6-month follow-up. Exclusion criteria were any concurrent ocular comorbidities. Primary outcomes measures were best spectacle-corrected visual acuity (BSCVA) and complications.
Mean thickness of NT-DSAEK grafts was 41.0 ± 7.5 μm (range 26-50 μm). At 1 month postoperatively, the DMEK group had significantly better mean BSCVA of 0.18 ± 0.20 logarithm of the minimum angle of resolution (logMAR) (20/33) compared with 0.28 ± 0.16 logMAR (20/40) for NT-NSAEK (P = 0.049). At 3, 6, and 12 months postoperatively, mean BSCVA was comparable between both groups [3 months: NT-DSAEK 0.17 ± 0.12 logMAR (20/30) versus DMEK 0.13 ± 0.17 (20/27), P = 0.31; 6 months: NT-DSAEK 0.11 ± 0.10 logMAR (20/26) versus DMEK 0.09 ± 0.10 (20/25), P = 0.63; 12 months: NT-DSAEK 0.07 ± 0.09 logMAR (20/24) versus DMEK 0.07 ± 0.11 logMAR (20/24), P = 0.95]. Other than 1 NT-DSAEK graft that was successfully rebubbled, no other complications were encountered in either group.
Compared with DMEK, NT-DSAEK provides comparable visual outcomes and complications rates.
比较超薄Descemet膜剥除自动内皮角膜移植术（NT-DSAEK）和Descemet膜内皮角膜移植术（DMEK）的视觉效果和并发症。
对28例连续的NT-DSAEK（小于或等于50μm）和DMEK病例进行前瞻性比较病例系列研究。纳入标准为诊断为Fuchs角膜内皮营养不良、存在人工晶状体或计划进行联合白内障手术/内皮角膜移植术，且至少随访6个月。排除标准为任何并发的眼部合并症。主要观察指标为最佳矫正视力（BSCVA）和并发症。
NT-DSAEK移植物的平均厚度为41.0±7.5μm（范围26 - 50μm）。术后1个月，DMEK组的平均BSCVA明显更好，最小分辨角对数（logMAR）为0.18±0.20（20/33），而NT-NSAEK组为0.28±0.16 logMAR（20/40）（P = 0.049）。术后3、6和12个月，两组的平均BSCVA相当[3个月：NT-DSAEK为0.17±0.12 logMAR（20/30），DMEK为0.13±0.17（20/27），P = 0.31；6个月：NT-DSAEK为0.11±0.10 logMAR（20/26），DMEK为0.09±0.10（20/25），P = 0.63；12个月：NT-DSAEK为0.07±0.09 logMAR（20/24），DMEK为0.07±0.11 logMAR（20/24），P = 0.95]。除1例成功再次注气的NT-DSAEK移植物外，两组均未出现其他并发症。
与DMEK相比，NT-DSAEK的视觉效果和并发症发生率相当。
