Machalińska Anna, Kuligowska Agnieszka, Kowalska Bogna, Safranow Krzysztof
First Department of Ophthalmology, Pomeranian Medical University, 70-111 Szczecin, Poland.
Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, 70-111 Szczecin, Poland.
J Clin Med. 2021 Oct 30;10(21):5119. doi: 10.3390/jcm10215119.
The need to provide a comparative analysis of corneal parameter changes compared to their preoperative values between Descemet membrane endothelial keratoplasty (DMEK) and ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) patients.
The study included 24 eyes after UT-DSAEK and 24 eyes after DMEK. Visual acuity, endothelial cell count (ECC), central corneal thickness (CCT), mean keratometry (MK), mean astigmatism (MA), astigmatism asymmetry (AA) and higher-order aberrations (HOAs) were assessed at baseline and 1, 3, 6 and 12 months after the surgery.
From the 3rd month post operation, ECC was higher in the DMEK eyes than in the UT-DSAEK eyes ( = 0.01). In a bivariate analysis that was adjusted for age, DMEK was associated with a smaller decrease in posterior MK at the 1-month (β = -0.49, = 0.002), 3-month (β = -0.50, < 0.001), 6-month (β = -0.58, < 0.001) and 12-month (β = -0.49, < 0.001) follow-up visits. There were no significant differences in changes in anterior or combined surface MK throughout the observation period. Accordingly, no significant differences in changes in MA, AA or HOAs compared to the baseline values were identified between the eyes after DMEK and UT-DSAEK at any follow-up time point.
UT-DSAEK seemed to be an easier and safer technique than DMEK while maintaining similar outcomes regarding irregular astigmatism and total keratometry values.
需要对Descemet膜内皮角膜移植术(DMEK)和超薄Descemet膜剥除自动内皮角膜移植术(UT-DSAEK)患者的角膜参数变化与其术前值进行比较分析。
该研究纳入了24只接受UT-DSAEK手术的眼睛和24只接受DMEK手术的眼睛。在基线以及术后1、3、6和12个月评估视力、内皮细胞计数(ECC)、中央角膜厚度(CCT)、平均角膜曲率(MK)、平均散光(MA)、散光不对称性(AA)和高阶像差(HOA)。
术后第3个月起,DMEK组眼睛的ECC高于UT-DSAEK组眼睛(P = 0.01)。在一项针对年龄进行调整的双变量分析中,DMEK与术后1个月(β = -0.49,P = 0.002)、3个月(β = -0.50,P < 0.001)、6个月(β = -0.58,P < 0.001)和12个月(β = -0.49,P < 0.001)随访时后表面MK的较小下降相关。在整个观察期内,前表面或联合表面MK的变化无显著差异。因此,在任何随访时间点,DMEK组和UT-DSAEK组眼睛与基线值相比,MA、AA或HOA的变化均无显著差异。
UT-DSAEK似乎是一种比DMEK更简便、更安全的技术,同时在不规则散光和总角膜曲率值方面保持相似的结果。