超薄撕囊自动化角膜内皮移植术。
Ultrathin Descemet stripping automated endothelial keratoplasty.
机构信息
Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
West Texas Eye Associates, El Paso, Texas, USA.
出版信息
Curr Opin Ophthalmol. 2019 Jul;30(4):264-270. doi: 10.1097/ICU.0000000000000575.
PURPOSE OF REVIEW
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).
RECENT FINDINGS
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.
SUMMARY
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.
目的综述
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。
最近的发现
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。
总结
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。
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