Ophthalmology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
Brody School of Medicine, Greenville, North Carolina, USA.
Curr Eye Res. 2021 Jul;46(7):930-935. doi: 10.1080/02713683.2020.1862236. Epub 2020 Dec 28.
: To determine the incidence of corneal graft rejection in patients with approximately 1 year of steroid therapy following uDSEK. A shortened course of corticosteroids may be beneficial and a viable option in Ultrathin Descemet's Stripping Endothelial Keratoplasty (uDSEK).: This retrospective cohort study evaluated corneal graft rejection rate in 170 cases of uDSEK that met inclusion criteria with approximately 1 year of steroid therapy. Corneal graft rejection was defined by anterior chamber cell/flare, keratic precipitates with/without corneal edema, and/or a rejection line. The following were collected retrospectively from January 1, 2005 through January 1, 2013: gender, age, race, indication for uDSEK, length of follow-up, length of steroid therapy. Continuous data were compared using Wilcoxon Rank Sum Test and categorical data were compared using Fisher's Exact Test.: The included eyes had an average length of steroid therapy of 431 days (range 85-720 days) with an average follow-up of 1274 days (range 395-3186 days). During the follow-up period without steroid, 5 of the 170 eyes were diagnosed with rejection (2.94%). Of the five eyes that experienced rejection, four eyes resolved after topical prednisone was reinstituted alone and did not require repeat uDSEK. The other eye was lost to follow-up. The cumulative probability of rejection after steroid cessation was calculated at 0.67% after 12 months, 2.20% after 18 months, 3.08% after 24 months, and 4.55% after 36 months.: Discontinuation of topical steroid at approximately 1 year after uDSEK results in a low rate of corneal graft rejection and may prove extended use unnecessary.
: 目的：确定 uDSEK 术后约 1 年接受类固醇治疗的患者中角膜移植物排斥的发生率。缩短皮质类固醇疗程可能是有益的，并且是超薄 Descemet 撕囊内皮角膜移植术 (uDSEK) 的可行选择。: 本回顾性队列研究评估了符合纳入标准且接受约 1 年类固醇治疗的 170 例 uDSEK 患者的角膜移植排斥率。通过前房细胞/闪光、伴有/不伴有角膜水肿的角膜后沉淀物和/或排斥线来定义角膜移植排斥。从 2005 年 1 月 1 日至 2013 年 1 月 1 日，回顾性收集以下资料：性别、年龄、种族、uDSEK 适应证、随访时间、类固醇治疗时间。使用 Wilcoxon 秩和检验比较连续数据，使用 Fisher 确切检验比较分类数据。: 纳入的眼睛平均接受类固醇治疗 431 天（范围 85-720 天），平均随访 1274 天（范围 395-3186 天）。在没有类固醇的随访期间，170 只眼中有 5 只（2.94%）被诊断为排斥。在经历排斥的五只眼中，四只眼在单独重新使用局部泼尼松后缓解，无需重复 uDSEK。另一只眼失访。在停止使用类固醇后 12 个月、18 个月、24 个月和 36 个月时，计算出排斥的累积概率分别为 0.67%、2.20%、3.08%和 4.55%。: uDSEK 术后约 1 年停止使用局部皮质类固醇可导致低排斥率，可能证明延长使用不必要。
