Cornea Department, The Helmholtz Moscow Institute of Eye Diseases (O.O., V.G.), Moscow, Russia ; Cornea Department, The Charles University (C.O.), Prague, Czech Republic ; Melles Cornea Clinic, Netherlands Institute for Innovative Ocular Surgery (NIIOS) (K.v.D., G.M.), Rotterdam, the Netherlands ; and Melles Cornea Clinic, NIIOS-USA (K.v.D., G.M.), San Diego, CA.
Eye Contact Lens. 2021 Apr 1;47(4):223-225. doi: 10.1097/ICL.0000000000000749.
Herein, we report the outcomes of intrastromal Descemet membrane (DM) transplantation in corneas with advanced keratoconus. Three eyes (three patients) showed advanced keratoconus. No eye underwent prior UV-cross-linking or any other ocular surgery. In all eyes, A donor DM was implanted into a mid-stromal pocket and clinical outcomes were evaluated up to 24 months after surgery. All procedures were uneventful. Up to 24 months postoperatively, the DM graft was well-positioned and barely visible within the recipient stroma; all corneas were clear. No eye showed signs of keratoconus progression throughout the follow-up. No changes were observed in uncorrected and best contact lens corrected visual acuity, central endothelial cell density, corneal thinnest point pachymetry, and maximum keratometry values. No early or late postoperative complications were observed. Intrastromal DM transplantation may be an alternative to intrastromal Bowman layer transplantation in advanced keratoconus, to postpone deep anterior lamellar or penetrating keratoplasty.
本文报告了在进展期圆锥角膜中进行基质内 Descemet 膜（DM）移植的结果。三例（三例患者）眼表现为进展期圆锥角膜。无一例眼行先前的紫外线交联或任何其他眼科手术。在所有眼中，将供体 DM 植入中基质袋中，并在手术后长达 24 个月评估临床结果。所有手术均顺利进行。术后 24 个月内，DM 移植物在受体基质内的位置良好，几乎不可见；所有角膜均清晰。在整个随访过程中，没有眼显示出圆锥角膜进展的迹象。未矫正视力和最佳接触镜矫正视力、中央角膜内皮细胞密度、角膜最薄点厚度和最大角膜曲率值均无变化。未观察到早期或晚期术后并发症。基质内 DM 移植可能是进展期圆锥角膜中基质内 Bowman 层移植的替代方法，可推迟深层前板层或穿透性角膜移植。
