From the Eastern Virginia Medical School and Virgina Eye Consultants, Norfolk, Virginia (Yeu); Department of Ophthalmology, UNIFESP/EPM and Instituto Suel Abujamra, Sao Paulo, Brazil (Gomes); Wills Eye Hospital, Philadelphia, Pennsylvania (Ayres); University of Toronto, Ontario, and the Eye Bank of Canada, Ontario Division, Ontario, Canada (Chan); Duke Eye Center, Durham, North Carolina (Gupta); Comprehensive Eyecare of Central Ohio, Westerville (Beckman); Department of Ophthalmology, Ohio State University, Columbus (Beckman); Gavin Herbert Eye Institute, University of California, Irvine (Farid); Department of Ophthalmology, University of Cincinnati, and Cincinnati Eye Institute, Cincinnati, Ohio (Holland); Duke Eye Center and Duke University School of Medicine, Durham, North Carolina (Kim); Weill Cornell Medicine and New York Presbyterian Hospital, New York, New York (Starr); Scripps Clinic Medical Group, La Jolla, California (Mah).
J Cataract Refract Surg. 2021 Oct 1;47(10):1345-1359. doi: 10.1097/j.jcrs.0000000000000634.
Over the past 2 decades, posterior lamellar keratoplasty (PLK) has emerged as an alternative to penetrating keratoplasty in the treatment of corneal endothelial disorders. The reasons for this trend include the search for a safer procedure to replace diseased endothelium that provides faster and better visual rehabilitation and reduces the need for postoperative care. Different surgical techniques, surgical instruments, devices, and lasers have been introduced to overcome technical difficulties, thus improving clinical outcomes. Yet, surgeons and eye banks must address the complications and limitations that arise during the transition to these new techniques. This review discusses the most significant aspects of the evolution of PLK, including a detailed description of current techniques and the direction of future treatment for corneal endothelial disease with the use of laser-assisted surgery, bioengineered corneas, cell therapy, and new pharmacologic therapy.
在过去的 20 年中，后板层角膜移植术（PLK）已成为穿透性角膜移植术治疗角膜内皮疾病的替代方法。出现这种趋势的原因包括寻找一种更安全的手术方法来替代病变的内皮，从而提供更快更好的视力恢复，并减少术后护理的需要。不同的手术技术、手术器械、设备和激光已经被引入，以克服技术困难，从而改善临床结果。然而，外科医生和眼库必须解决在向这些新技术过渡过程中出现的并发症和局限性。这篇综述讨论了 PLK 发展的最重要方面，包括当前技术的详细描述，以及使用激光辅助手术、生物工程角膜、细胞疗法和新的药物治疗治疗角膜内皮疾病的未来治疗方向。
