Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
West Texas Eye Associates, El Paso, Texas, USA.
Curr Opin Ophthalmol. 2019 Jul;30(4):264-270. doi: 10.1097/ICU.0000000000000575.
Endothelial keratoplasty has evolved tremendously since its inception. Thick Descemet stripping automated endothelial keratoplasty (DSAEK) grafts have made sway for slimmer ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK). This review discusses the recent literature comparing outcomes of UT-DSAEK, DSAEK, and Descemet membrane endothelial keratoplasty (DMEK).
DMEK provides quick visual recovery and has remarkably low incidence of graft rejection. However, the learning curve is long compared to DSAEK. UT-DSAEK utilizes donor grafts less than 100-μm thick. Recent studies comparing DMEK and UT-DSAEK have shown DMEK has better visual outcomes with similar rejection rates.
UT-DSAEK remains an excellent surgical option for endothelial keratoplasty in eyes with complex anterior segment anatomy. The visual outcomes after UT-DSAEK have been shown to be superior when compared with DSAEK. Recent studies show that DMEK provides better visual outcomes compared with UT-DSAEK.
自诞生以来，内皮角膜移植术已经取得了巨大的发展。厚板层 Descemet 撕除式内皮角膜移植术（DSAEK）移植物已经为更薄的超薄板层 Descemet 撕除式内皮角膜移植术（UT-DSAEK）让路。本综述讨论了比较 UT-DSAEK、DSAEK 和 Descemet 膜内皮角膜移植术（DMEK）的最新文献。
DMEK 提供快速的视觉恢复，且排斥反应发生率显著降低。然而，与 DSAEK 相比，其学习曲线较长。UT-DSAEK 使用厚度小于 100μm 的供体移植物。最近比较 DMEK 和 UT-DSAEK 的研究表明，DMEK 具有更好的视觉结果，且排斥反应率相似。
UT-DSAEK 仍然是前节解剖复杂的眼内皮角膜移植的优秀手术选择。与 DSAEK 相比，UT-DSAEK 的视觉效果更好。最近的研究表明，与 UT-DSAEK 相比，DMEK 提供更好的视觉效果。
