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全身性疾病对深板层角膜内皮移植术中供体准备的影响。

Effects of Systemic Diseases on Graft Preparation in Descemet Membrane Endothelial Keratoplasty.

机构信息

Department of Ophthalmology (B.Ö.), Erciş Şehit Rıdvan Çevik State Hospital, Van, Turkey; and Department of Ophthalmology (Y.K., B.K.), Adana City Training and Research Hospital, Adana, Turkey.

出版信息

Eye Contact Lens. 2022 Dec 1;48(12):527-533. doi: 10.1097/ICL.0000000000000939. Epub 2022 Oct 6.

Abstract

OBJECTIVES

To evaluate the effects of the systemic diseases and drugs of the donor on Descemet membrane (DM) graft preparation.

METHODS

Seventy-eight corneas of 58 donors, of whom the DM grafts were used in Descemet membrane endothelial keratoplasty (DMEK) surgery, between January 2018 and January 2020, were enrolled in this retrospective study. The hospital records of the donors were analyzed. Age, sex, blood type, systemic diseases, and drugs; complete blood count; biochemistry panel for liver and kidney functions in the past 48 hours; and the drugs used in the hospital, if any, in the past 24 hours were recorded. The grafts with tears that occurred while preparation were included in group 1, and the successful grafts with no tears were included in group 2.

RESULTS

There were no statistically significant differences in the characteristics of the donors between groups. However, breast cancer and the use of sevelamer were found to be significantly higher in group 1 ( P =0.010, P =0.033, respectively). No statistically significant difference in the use of other drugs was found between groups.

CONCLUSION

Although diabetic donors have been reported to be inappropriate candidates for the preparation of DM grafts for DMEK, most of the donors with several systemic diseases including diabetes can be used in DMEK surgery, with the right technique in DM graft preparation.

摘要

目的

评估供体的系统性疾病和药物对角膜后弹力层(Descemet membrane,DM)移植物准备的影响。

方法

本回顾性研究纳入了 2018 年 1 月至 2020 年 1 月期间 58 名供体的 78 枚角膜,这些角膜的 DM 移植物用于行 Descemet 膜内皮角膜移植术(Descemet membrane endothelial keratoplasty,DMEK)。分析供体的医院记录,包括年龄、性别、血型、系统性疾病和药物、全血细胞计数、过去 48 小时的肝肾功能生化检查以及过去 24 小时内使用的药物(如有)。准备过程中发生撕裂的移植物被纳入第 1 组,而未撕裂的成功移植物被纳入第 2 组。

结果

两组供体的特征无统计学差异。然而,第 1 组中乳腺癌和使用司维拉姆的比例显著更高(P=0.010,P=0.033)。两组间其他药物的使用无统计学差异。

结论

尽管有报道称糖尿病供体不适合准备用于 DMEK 的 DM 移植物,但大多数患有包括糖尿病在内的几种系统性疾病的供体可以在 DMEK 手术中使用,只要在 DM 移植物准备过程中使用正确的技术。

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