Department of Ophthalmology, Juntendo University Graduate School of Medicine, 3-1-3 Hongo Bunkyo-ku, Tokyo, 113-8431, Japan.
Jpn J Ophthalmol. 2024 Jan;68(1):50-56. doi: 10.1007/s10384-023-01038-y. Epub 2024 Jan 2.
To assess the outcomes of Descemet stripping automated endothelial keratoplasty (DSAEK) via a sclerocorneal frown incision.
Retrospective comparative study.
The outcomes of Descement stripping endothelial keratoplasty (DSAEK) were retrospectively compared between 36 patients (36 eyes) who underwent surgery via a 3.8-mm frown incision (frown incision group) and 20 patients (20 eyes) who underwent surgery via a 4.6-mm straight incision (straight incision group). In all patients, an NS Endo-Inserter was used as the graft inserter and the incision for a frown incision was via the superior sclerocorneal site and for the straight incision via the temporal cornea. DSAEK was performed by the standard technique, except for the incision. At 1 year after surgery, the two groups were compared with respect to the visual acuity, decrease of corneal endothelial cell density, the severity of corneal astigmatism (diopters), the number of sutures for wound closure, and intraoperative/postoperative complications.
There was no significant difference between the two groups in terms of postoperative visual acuity, corneal astigmatism, and intraoperative/postoperative complications one year after surgery. On the other hand, the number of sutures required for wound closure was 1.13 ± 0.42 in the frown incision group, whereas in the straight incision group, it was 3.20 ± 0.40, showing a significant difference (P<0.001). In addition, there was no decreased corneal endothelial cell density associated with the reduction in incision width.
A sclerocorneal frown incision is useful for performing DSAEK with an NS Endo-Inserter as it does not affect endothelial cell loss despite its short incision width.
评估通过巩膜角膜皱眉切口进行的撕囊自动化内皮角膜移植术(DSAEK)的结果。
回顾性比较研究。
回顾性比较了 36 名患者(36 只眼)通过 3.8mm 皱眉切口(皱眉切口组)和 20 名患者(20 只眼)通过 4.6mm 直切口(直切口组)进行撕囊内皮角膜移植术(DSAEK)的结果。所有患者均使用 NS Endo-Inserter 作为移植物植入器,皱眉切口通过巩膜上方部位,直切口通过颞侧角膜。除切口外,DSAEK 均采用标准技术进行。术后 1 年,比较两组视力、角膜内皮细胞密度下降、角膜散光程度(屈光度)、伤口缝合缝线数量以及术中/术后并发症。
术后 1 年,两组患者术后视力、角膜散光和术中/术后并发症无显著差异。另一方面,皱眉切口组伤口缝合缝线数量为 1.13±0.42,直切口组为 3.20±0.40,差异有统计学意义(P<0.001)。此外,切口宽度减小与角膜内皮细胞密度降低无关。
巩膜角膜皱眉切口在使用 NS Endo-Inserter 进行 DSAEK 时很有用,因为尽管切口宽度较短,但不会影响内皮细胞丢失。