Department of Ophthalmology, Tokai University School of Medicine, Kanagawa, Japan.
Department of Ophthalmology, Yokohama Minami Kyosai Hospital, Kanagawa, Japan.
Cornea. 2021 Jun 1;40(6):690-695. doi: 10.1097/ICO.0000000000002535.
To evaluate changes in the anterior chamber of eyes that have undergone Descemet membrane endothelial keratoplasty (DMEK) and to identify factors that affect these changes.
This retrospective study included 25 pseudophakic eyes of 25 patients who underwent DMEK. We determined the preoperative and postoperative values of the best spectacle-corrected visual acuity, spherical equivalent (SE), anterior chamber volume (ACV), anterior chamber depth (ACD), central corneal thickness (CCT), and scleral spur angle (SSA) evaluated using anterior segment optical coherence tomography and iris damage score and iris posterior synechiae score. We defined ∆ as the average change rate from the preoperative to postoperative value for each factor at 1 month (SE at 6-12 months) postoperatively. We also analyzed correlations between ∆ACV, ∆SE, and other preexisting factors.
Compared with the preoperative ACV value (128 ± 28 mm3), the postoperative value significantly increased to 155 ± 21 mm3 (P < 0.001); ∆SE was +1.01 ± 1.09 diopters. ∆ACV was negatively correlated with preoperative ACD (R = 0.643, P < 0.001) and SSA (R = 0.555, P = 0.001) and positively correlated with ∆ACD (R = 0.799, P < 0.001) and ∆SSA (R = 0.608, P < 0.001). ∆CCT, iris damage score, and iris posterior synechiae score were not significantly correlated with ∆ACV. ∆SE was positively correlated with ∆ACV, ∆ACD, and ∆SSA (R = 0.680, 0.455, and 0.478; P < 0.001, <0.05, and <0.05, respectively).
An increase in the ACV and hyperopic change was noted after successful DMEK, especially in eyes with narrow-angled shallow anterior chambers.
评估接受 Descemet 膜内皮角膜移植术（DMEK）后眼前房的变化，并确定影响这些变化的因素。
本回顾性研究纳入了 25 例 25 只接受 DMEK 的假性剥脱眼。我们通过眼前节光学相干断层扫描评估了术前和术后最佳矫正视力、等效球镜（SE）、前房容积（ACV）、前房深度（ACD）、中央角膜厚度（CCT）和巩膜突角度（SSA），以及虹膜损伤评分和虹膜后粘连评分。我们将术后 1 个月（术后 6-12 个月 SE）每个因素的术前值与术后值的平均变化率定义为 ∆。我们还分析了 ∆ACV、∆SE 与其他现有因素之间的相关性。
与术前 ACV 值（128 ± 28 mm3）相比，术后值显著增加至 155 ± 21 mm3（P < 0.001）；∆SE 为 +1.01 ± 1.09 屈光度。∆ACV 与术前 ACD（R = 0.643，P < 0.001）和 SSA（R = 0.555，P = 0.001）呈负相关，与 ∆ACD（R = 0.799，P < 0.001）和 ∆SSA（R = 0.608，P < 0.001）呈正相关。CCT、虹膜损伤评分和虹膜后粘连评分与 ∆ACV 无显著相关性。∆SE 与 ∆ACV、∆ACD 和 ∆SSA 呈正相关（R = 0.680、0.455 和 0.478；P < 0.001、<0.05 和 <0.05）。
成功的 DMEK 后，前房容积增加，远视变化明显，尤其是在前房角窄浅的眼中。
