Division of Ophthalmology, Department of Visual Sciences, Nihon University School of Medicine, Ohyaguchikami-machi 30-1, Itabashi-ku, Tokyo, 173-8610, Japan.
Department of Ophthalmology, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan.
Sci Rep. 2022 Apr 28;12(1):6936. doi: 10.1038/s41598-022-10939-w.
This study evaluated changes in corneal nerves and the number of dendritic cells (DCs) in corneal basal epithelium following Descemet membrane endothelial keratoplasty (DMEK) surgery for bullous keratopathy (BK). Twenty-three eyes from 16 consecutive patients that underwent DMEK for BK were included. Eyes of age-matched patients that underwent pre-cataract surgery (12 eyes) were used as controls. In vivo confocal microscopy was performed pre- and postoperatively at 6, 12, and 24 months. Corneal nerve length, corneal nerve trunks, number of branches, and the number of DCs were determined. The total corneal nerve length of 1634.7 ± 1389.1 μm/mm before surgery was significantly increased in a time-dependent manner to 4485.8 ± 1403.7 μm/mm, 6949.5 ± 1477.1 μm/mm, and 9389.2 ± 2302.2 μm/mm at 6, 12, and 24 months after DMEK surgery, respectively. The DC density in BK cornea pre- and postoperatively at 6 months was significantly higher than in the controls, and decreased postoperatively at 12 and 24 months and was significantly lower than that at 6 months postoperatively. Thus, our results suggest that DMEK can repair and normalize the corneal environment.
本研究评估了在用于大疱性角膜病变（BK）的 Descemet 膜内皮角膜移植（DMEK）手术后角膜神经和角膜基底上皮树突状细胞（DC）数量的变化。纳入了 16 例连续接受 DMEK 治疗 BK 的 23 只眼。将接受白内障术前手术（12 只眼）的年龄匹配患者的眼睛作为对照。在术前和术后 6、12 和 24 个月进行活体共聚焦显微镜检查。确定角膜神经长度、角膜神经干、分支数量和 DC 数量。手术前总角膜神经长度为 1634.7±1389.1μm/mm，呈时间依赖性增加，至 DMEK 手术后 6、12 和 24 个月分别为 4485.8±1403.7μm/mm、6949.5±1477.1μm/mm 和 9389.2±2302.2μm/mm。BK 角膜术前和术后 6 个月的 DC 密度明显高于对照组，术后 12 和 24 个月下降，明显低于术后 6 个月。因此，我们的结果表明 DMEK 可以修复和使角膜环境正常化。
