Tase Saho, Shimizu Toshiki, Hayashi Takahiko, Tabuchi Hitoshi, Niimi Koji, Mizuki Nobuhisa, Kato Naoko
Niimi Eye Institute, Hyogo, Japan.
Department of Ophthalmology, Yokohama City University Hospital, Kanagawa, Japan.
BMC Ophthalmol. 2019 May 28;19(1):119. doi: 10.1186/s12886-019-1130-1.
To evaluate the clinical outcomes and features of Descemet's membrane endothelial keratoplasty (DMEK) for eyes with pseudoexfoliation syndrome (PEX).
In this retrospective study, 37 DMEK cases were reviewed from available medical records. Patients who exhibited endothelial dysfunction derived from PEX or Fuchs endothelial corneal dystrophy (FECD) and successfully underwent cataract surgery about four weeks before DMEK were enrolled. The best spectacle-corrected visual acuity (BSCVA), central corneal thickness (CCT), endothelial cell density (ECD), and incidence of intra-operative/post-operative complications of DMEK were analyzed.
This study included 14 eyes of 14 patients (PEX: n = 6, FECD: n = 8). There was no primary graft failure. In the PEX group, BSCVA improved from 0.67 ± 0.28 at the preoperative point to 0.43 ± 0.14 at 1 month, 0.27 ± 0.10 at 3 months, and 0.19 ± 0.08 at 6 months after DMEK. The donor corneal ECD was 2704 ± 225 cells/mm at the preoperative point and decreased to 1691 ± 498 cells/mm at 1 month, 1425 ± 366 cells/mm at 3 months, and 1281 ± 340 cells/mm (52.7 ± 11.7% less than ECD of the donor graft) at 6 months after DMEK. None of the patients required rebubbling. When compared with the FECD group, no statistical difference was observed in CCT (p = 0.821); BSCVA (p = 0.001) and the reduction rate of ECD (p = 0.010) were relatively worse.
DMEK is effective for the treatment of endothelial dysfunction due to PEX.
评估Descemet膜内皮角膜移植术（DMEK）治疗假性剥脱综合征（PEX）患者眼睛的临床疗效和特征。
在这项回顾性研究中，从现有病历中回顾了37例DMEK病例。纳入那些因PEX或Fuchs内皮角膜营养不良（FECD）导致内皮功能障碍且在DMEK手术前约四周成功接受白内障手术的患者。分析了DMEK的最佳矫正视力（BSCVA）、中央角膜厚度（CCT）、内皮细胞密度（ECD）以及术中/术后并发症的发生率。
本研究纳入了14例患者的14只眼睛（PEX组：n = 6，FECD组：n = 8）。未发生原发性移植失败。在PEX组中，DMEK术后1个月时BSCVA从术前的0.67±0.28提高到0.43±0.14，3个月时为0.27±0.10，6个月时为0.19±0.08。供体角膜ECD术前为2704±225个细胞/mm，DMEK术后1个月降至1691±498个细胞/mm，3个月时为1425±366个细胞/mm，6个月时为1281±340个细胞/mm（比供体移植物的ECD减少了52.7±11.7%）。所有患者均无需再次注气。与FECD组相比，CCT无统计学差异（p = 0.821）；BSCVA（p = 0.001）和ECD降低率（p = 0.010）相对较差。
DMEK对治疗PEX所致内皮功能障碍有效。
