Agha Bishr, Dawson Daniel G, Kohnen Thomas, Schmack Ingo
Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany.
Department of Ophthalmology, University of Florida, Gainesville, FL.
Cornea. 2019 Sep;38(9):1083-1092. doi: 10.1097/ICO.0000000000002016.
To evaluate Scheimpflug corneal densitometry (CD) in patients undergoing secondary Descemet membrane endothelial keratoplasty (DMEK) after previous Descemet stripping automated endothelial keratoplasty or DMEK surgery.
This was a retrospective institutional case series of 37 eyes of 37 patients. Two secondary DMEK groups, group 1A (n = 12 DMEK after Descemet stripping automated endothelial keratoplasty), group 1B (n = 11 repeat DMEK), and group 2 (n = 14 primary DMEK for Fuchs endothelial dystrophy) were formed. CD was obtained preoperatively, 1, 6, and 12 months postoperatively. In addition, corrected distance visual acuity, central corneal thickness, and endothelial cell density were assessed.
A significant decrease in grayscale units was observed in the 0- to 2-mm and 2- to 6-mm zones in all groups. For the 0- to 2-mm zone, values decreased from 49.11 ± 17.96 preoperatively to 22.87 ± 5.24 at 12 months (group 1A), from 45.16 ± 9.22 to 24.53 ± 14.21 (group 1B), and from 27.90 ± 8.30 to 16.64 ± 1.51 (group 2) (P < 0.01). Group 2 showed significantly lower grayscale units than groups 1A and 1B preoperatively and 12 months postoperatively in the 0- to 2-mm and 2- to 6-mm zones. Significant correlations of CD and corrected distance visual acuity were found in groups 1A and 1B in the 0- to 2-mm zone at 12 months. There were no significant correlations between CD and central corneal thickness postoperatively.
A decrease in CD could be demonstrated in secondary DMEK. Nevertheless, CD values remained significantly higher than in controls. This might point out the relevance of secondary corneal structural changes.
评估在先前接受过Descemet膜剥除自动内皮角膜移植术或Descemet膜内皮角膜移植术（DMEK）的患者中，行二次Descemet膜内皮角膜移植术（DMEK）时的Scheimpflug角膜密度测量法（CD）。
这是一项对37例患者的37只眼进行的回顾性机构病例系列研究。形成了两个二次DMEK组，1A组（12例在Descemet膜剥除自动内皮角膜移植术后行DMEK），1B组（11例重复行DMEK），以及2组（14例因Fuchs内皮营养不良行初次DMEK）。在术前、术后1个月、6个月和12个月获取CD值。此外，评估矫正远视力、中央角膜厚度和内皮细胞密度。
所有组在0至2毫米和2至6毫米区域的灰度单位均显著降低。对于0至2毫米区域，12个月时，1A组的值从术前的49.11±17.96降至22.87±5.24，1B组从45.16±9.22降至24.53±14.21，2组从27.90±8.30降至16.64±1.51（P<0.01）。2组在术前以及术后12个月时，在0至2毫米和2至6毫米区域的灰度单位显著低于1A组和1B组。12个月时，1A组和1B组在0至2毫米区域的CD与矫正远视力存在显著相关性。术后CD与中央角膜厚度之间无显著相关性。
二次DMEK可显示CD降低。然而，CD值仍显著高于对照组。这可能指出了二次角膜结构改变的相关性。
