Feizi Sepehr, Javadi Mohammad Ali
Ocular Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Ophthalmic Vis Res. 2019 Jan-Mar;14(1):18-26. doi: 10.4103/jovr.jovr_55_17.
To evaluate the effects of donor graft thickness on postoperative best spectacle-corrected visual acuity (BSCVA), refractive outcomes, endothelial cell density (ECD) and function, intraocular pressure (IOP), and postoperative complications after Descemet stripping automated endothelial keratoplasty (DSAEK).
This retrospective, interventional case series enrolled 77 eyes of 64 patients who underwent DSAEK with or without simultaneous cataract surgery. Clinical outcomes, including BSCVA, refraction, keratometric astigmatism, IOP, and ECD were assessed at the final follow-up examination. Univariate analyses were used to investigate the effects of postoperative donor graft thickness on clinical outcomes and complications.
The mean patient age was 62.3 ± 15.6 years, and the patients were followed for 26.2 ± 20.9 months postoperatively. The mean postoperative central graft thickness was 102.4 ± 31.6 μm. In the univariate analysis, postoperative central graft thickness was significantly associated with postoperative IOP ( = 0.005), central recipient thickness ( = 0.002), and ECD ( = 0.016). No significant association was found for central graft thickness with postoperative BSCVA ( = 0.70), spherical equivalent refraction ( = 0.33), keratometric astigmatism ( = 0.27), graft detachment ( = 0.16), graft decentration ( = 0.17), high IOP ( = 0.53), or endothelial rejection ( = 0.88).
This study failed to demonstrate any significant correlation between graft thickness and BSCVA. Attempting to minimize graft thickness might not have the desired outcome regarding endothelial cell density and function. Increased graft thickness could negatively impact the accuracy of IOP measurements after DSAEK.
评估供体植片厚度对Descemet膜剥除自动角膜内皮移植术（DSAEK）术后最佳矫正视力（BSCVA）、屈光结果、内皮细胞密度（ECD）及功能、眼压（IOP）和术后并发症的影响。
本回顾性、干预性病例系列纳入了64例行DSAEK手术（有或无同期白内障手术）患者的77只眼。在最终随访检查时评估临床结果，包括BSCVA、屈光、角膜散光、IOP和ECD。采用单因素分析研究术后供体植片厚度对临床结果和并发症的影响。
患者平均年龄为62.3±15.6岁，术后随访26.2±20.9个月。术后中央植片平均厚度为102.4±31.6μm。单因素分析中，术后中央植片厚度与术后IOP（P = 0.005）、中央受体厚度（P = 0.002）和ECD（P = 0.016）显著相关。未发现中央植片厚度与术后BSCVA（P = 0.70）、等效球镜度屈光（P = 0.33）、角膜散光（P = 0.27）、植片脱离（P = 0.16）、植片偏心（P = 0.17）、高眼压（P = 0.53）或内皮排斥反应（P = 0.88）有显著相关性。
本研究未能证明植片厚度与BSCVA之间存在任何显著相关性。试图最小化植片厚度在ECD和功能方面可能无法达到预期效果。植片厚度增加可能会对DSAEK术后IOP测量的准确性产生负面影响。
