Cornea and Ocular Surface Services, LJ Eye Institute, Ambala City, India.
Cornea. 2021 Aug 1;40(8):972-976. doi: 10.1097/ICO.0000000000002701.
To report our early experiences with Descemet membrane endothelial keratoplasty (DMEK) in congenital hereditary endothelial dystrophy (CHED).
Retrospective analysis of medical records of eyes with CHED that underwent DMEK between January 1, 2018, and April 30, 2019, and had a minimum of 1-year follow-up.
Three eyes of 2 CHED patients (a 10-year-old girl and a 22-year-old man) were included. Both had decreased vision and hazy corneas from birth and underwent DMEK during the study period. Surgery was performed by a single surgeon and was uneventful in all 3 eyes. Within 1 month of surgery, the corneal edema cleared, and vision improved significantly. The mean decimal visual acuity improved from 0.15 ± 0.08 (baseline) to 0.33 ± 0.19 at 3 months. The mean central corneal thickness improved from 928 ± 2.3 μm (baseline) to 555.3 ± 25.8 μm at 3 months. The final visual outcome was less in 1 eye because of dense amblyopia. In all 3 eyes, a subtle stromal haze persisted even after resolution of edema. One eye had graft rejection 7 months after surgery because of discontinuation of medications, effectively managed by increasing the frequency of topical steroids.
DMEK may be a viable option in phakic eyes with CHED.
报告我们在先天性遗传性内皮营养不良（CHED）中进行 Descemet 膜内皮角膜移植术（DMEK）的早期经验。
回顾性分析 2018 年 1 月 1 日至 2019 年 4 月 30 日期间接受 DMEK 治疗且至少随访 1 年的 CHED 眼的病历。
纳入 2 例 CHED 患者（10 岁女孩和 22 岁男性）的 3 只眼。两人均自出生起视力下降，角膜混浊，在研究期间接受了 DMEK。所有 3 只眼均由同一位外科医生进行手术，过程均顺利。术后 1 个月内，角膜水肿消退，视力明显改善。术后 3 个月时，平均十进制视力从 0.15±0.08（基线）提高至 0.33±0.19。平均中央角膜厚度从 928±2.3μm（基线）降低至 555.3±25.8μm。1 只眼由于弱视严重，最终视力较差。在所有 3 只眼中，即使在水肿消退后，仍存在轻微的基质混浊。1 只眼术后 7 个月因停药发生移植物排斥反应，通过增加局部皮质类固醇的频率有效地进行了管理。
DMEK 可能是 CHED 伴晶状体眼的可行选择。
