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经皮微切口酶解角膜内皮移植术(DMEK)中应用与不应用含有葡聚糖的介质与标准 DMEK 术后临床效果比较:前瞻性初步研究。

Comparison of clinical outcomes after precut DMEK with or without dextran-containing medium compared to standard DMEK: a prospective pilot study.

机构信息

Eye Clinic Sulzbach, Knappschaft Hospital Saar, An der Klinik 10, 66280, Sulzbach, Germany.

Klaus Heimann Eye Research Institute (KHERI), Knappschaft Hospital Saar, Sulzbach, Germany.

出版信息

Int Ophthalmol. 2022 Feb;42(2):401-409. doi: 10.1007/s10792-021-02056-w. Epub 2021 Oct 21.

Abstract

PURPOSE

To investigate the clinical outcome and complication rate of precut Descemet membrane endothelial keratoplasty (DMEK) in two different culture conditions, dextran-containing and dextran-free medium, and compare the results with the current standard DMEK procedure.

METHODS

A prospective study of 32 eyes suffering from Fuchs endothelial dystrophy were scheduled for DMEK with a follow-up of one year. The eyes were divided into four subgroups. Group + D (n = 7) received a precut DMEK stored in dextran-containing transport medium, and Group - D (n = 9) received a precut DMEK without dextran-containing medium. The respective fellow eyes received a standard DMEK (S) (preparation directly prior to surgery) stored in dextran-containing medium (S-D + ; n = 7) or without (S-D-; n = 9).

RESULTS

Clinical outcome (visual acuity, endothelial cell count, central corneal thickness) and rebubbling rate were comparable for all four groups. None of the patients had a graft failure.

CONCLUSION

The preliminary data of the pilot study show that precut liquid-bubble DMEK leads to comparable clinical results regardless of dextran-containing or dextran-free organ culture medium and is further comparable to the standard DMEK procedure.

摘要

目的

研究两种不同培养条件下(含葡聚糖和无葡聚糖培养基)前切割 Descemet 膜内皮角膜移植术(DMEK)的临床效果和并发症发生率,并与目前的标准 DMEK 手术进行比较。

方法

对 32 只患有 Fuchs 内皮营养不良的眼睛进行前瞻性研究,计划进行 DMEK 手术,随访一年。这些眼睛被分为四组。+D 组(n=7)接受含葡聚糖的运输培养基中储存的前切割 DMEK,-D 组(n=9)接受不含葡聚糖的前切割 DMEK。各自的对侧眼接受含葡聚糖的标准 DMEK(S)(手术前直接准备)(S-D+;n=7)或不含葡聚糖(S-D-;n=9)。

结果

所有四组的临床结果(视力、内皮细胞计数、中央角膜厚度)和再灌流率均相似。没有患者发生移植物失败。

结论

初步研究数据表明,无论使用含葡聚糖还是无葡聚糖的器官培养培养基,前切割液泡 DMEK 均可产生相似的临床效果,并且与标准 DMEK 手术进一步相似。

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