Módis László, Lukács Miklós, Makhoul Sára
1 Debreceni Egyetem, Általános Orvostudományi Kar, Szemészeti Tanszék Debrecen, Nagyerdei krt. 98., 4032 Magyarország.
Orv Hetil. 2023 Jul 16;164(28):1087-1093. doi: 10.1556/650.2023.32822.
Corneal transplantation (keratoplasty) is necessary when various disorders result in corneal opacities with severe visual loss that cannot be treated conservatively, or the regular structure and curvature of the cornea is distorted, and its function is lost. Among human transplantation, keratoplasty is the most successful surgical procedure. In recent decades, penetrating keratoplasties have been increasingly replaced by lamellar techniques, where only the abnormal layer of the cornea is transplanted. The anterior form is deep anterior lamellar keratoplasty (DALK), recommended mainly for keratoconus. The main forms of posterior lamellar keratoplasty are Descemet's stripping automated endothelial keratoplasty (DSAEK) and Descemet's membrane endothelial keratoplasty (DMEK). The indications are bullous keratopathy after cataract surgery with endothelial destruction and Fuchs endothelial dystrophy. Lamellar keratoplasty has several advantages over penetrating surgery. Postoperative visual acuity is better, wound healing, patient rehabilitation are faster and the course of any immune rejection is milder and can be better managed. Orv Hetil. 2023; 164(28): 1087-1093.
当各种疾病导致角膜混浊并伴有严重视力丧失且无法保守治疗时，或者角膜的正常结构和曲率发生扭曲且功能丧失时，角膜移植（角膜成形术）是必要的。在人体移植中，角膜移植是最成功的外科手术。近几十年来，穿透性角膜移植术越来越多地被板层技术所取代，在板层技术中，仅移植角膜的异常层。前一种形式是深板层角膜移植术（DALK），主要推荐用于圆锥角膜。后板层角膜移植术的主要形式是Descemet膜剥脱自动内皮角膜移植术（DSAEK）和Descemet膜内皮角膜移植术（DMEK）。其适应症为白内障手术后伴有内皮破坏的大泡性角膜病变和Fuchs内皮营养不良。板层角膜移植术相对于穿透性手术有几个优点。术后视力更好，伤口愈合更快，患者康复更快，任何免疫排斥反应的过程更轻且更容易管理。《匈牙利医学周报》。2023年；164(28):1087 - 1093。
