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不断发展的技术和适应证：Descemet 膜内皮角膜移植术。

Evolving Techniques and Indications of Descemet Membrane Endothelial Keratoplasty.

机构信息

University of Health Sciences Turkey, Ankara City Hospital, Ankara, Turkey.

Netherlands Institute For Innovative Ocular Surgery (NIIOS), Rotterdam, The Netherlands.

出版信息

Turk J Ophthalmol. 2021 Dec 28;51(6):381-392. doi: 10.4274/tjo.galenos.2021.28227.

DOI:10.4274/tjo.galenos.2021.28227
PMID:34963266
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8715656/
Abstract

Endothelial keratoplasty has replaced traditional penetrating keratoplasty for the treatment of corneal endothelial dysfunction. It offers faster, more predictable, stable visual recovery and low rejection rates while the surgery itself is less invasive. Descemet membrane endothelial keratoplasty (DMEK) is currently the gold standard for the treatment of Fuchs endothelial dystrophy, bullous keratopathy, and corneal edema after cataract surgery. Its favorable long-term outcomes are increasingly reported by large study groups. This review summarizes the current literature on new DMEK techniques, including size and shape modifications, new graft delivery techniques, and surgical pearls for challenging cases like eyes with glaucoma, glaucoma tubes, and failed penetrating keratoplasties.

摘要

内皮角膜移植术已取代传统的穿透性角膜移植术，用于治疗角膜内皮功能障碍。它提供了更快、更可预测、更稳定的视力恢复和较低的排斥率，而手术本身的侵入性更小。Descemet 膜内皮角膜移植术（DMEK）目前是治疗 Fuchs 内皮营养不良、大疱性角膜病变和白内障手术后角膜水肿的金标准。越来越多的大型研究组报告了其良好的长期结果。本文综述了目前关于 DMEK 新技术的文献，包括大小和形状的改进、新的移植物传递技术以及青光眼、青光眼引流管和穿透性角膜移植失败等复杂病例的手术要点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acb8/8715656/635153718385/TJO-51-381-g5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acb8/8715656/ffe57d8dea7e/TJO-51-381-g1.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acb8/8715656/7c01b8869f5d/TJO-51-381-g4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acb8/8715656/635153718385/TJO-51-381-g5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acb8/8715656/ffe57d8dea7e/TJO-51-381-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acb8/8715656/b518d1260135/TJO-51-381-g2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acb8/8715656/4eaf4b32948b/TJO-51-381-g3.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acb8/8715656/635153718385/TJO-51-381-g5.jpg

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本文引用的文献

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Acta Ophthalmol. 2021 Aug;99(5):569-574. doi: 10.1111/aos.14645. Epub 2020 Oct 29.
3
Four-Year Survival of Descemet Membrane Endothelial Keratoplasty in Patients With Previous Glaucoma Surgery.
J Clin Med. 2025 May 18;14(10):3534. doi: 10.3390/jcm14103534.
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A historical view of the development of corneal transplantation: from penetrating keratoplasty to selective transplantation of the finest corneal layers.角膜移植发展的历史回顾：从穿透性角膜移植到最精细角膜层的选择性移植。
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The surgical management of a patient with Fuchs endothelial dystrophy and cataracts.一名患有富克斯内皮营养不良和白内障患者的手术治疗
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