Olafsdottir Thorbjörg, Hootak Faisal, Forslund Carina, Olafsdottir Eydis, Gustafsson Ingemar
Department of Ophthalmology, Department of Clinical Sciences, Skåne University Hospital, Lund University, Lund, Sweden.
Department of Ophthalmology, Centralsjukhuset Kristianstad, Kristianstad, Sweden.
Acta Ophthalmol. 2025 May;103(3):281-288. doi: 10.1111/aos.16791. Epub 2024 Nov 7.
To analyse graft detachment rates after Descemet stripping automated endothelial keratoplasty (DSAEK) using surgeon-cut grafts and pre-cut grafts transported in different mediums.
A retrospective study of graft detachment rates including 265 surgeries (240 patients) performed between 2019 and 2023. The DSAEK grafts were either surgeon-cut (n = 135) or pre-cut and transported in a dextran-containing medium (n = 82) or in a dextran-free medium (n = 48). All surgeries were performed by a single surgeon (I.G.). The surgeries were categorised according to whether the recipients' eyes had, or did not have, factors associated with an increased risk of graft detachment. Detachment rates were compared for all patients receiving the different kinds of graft, and only for those without risk factors.
A significantly higher detachment rate was found among patients receiving pre-cut grafts transported in a dextran-containing medium (32.9%), compared to surgeon-cut grafts (14.1%, p = 0.002), and pre-cut grafts transported in a dextran-free medium (6.3%, p = 0.002) for all recipients (those with and without risk factors for graft detachment). When analysing recipients without risk factors for graft detachment, the detachment rate was still significantly higher with pre-cut tissue transported in a dextran-containing medium (26.9%), compared to surgeon-cut tissue (8.3%, p = 0.002) and pre-cut tissue transported in a dextran-free medium (3.6%, p = 0.01).
The use of pre-cut DSAEK tissue transported in a dextran-containing medium significantly increases the risk of graft detachment requiring re-bubbling.
分析使用手术医生切割的植片和在不同介质中运输的预切割植片进行后弹力层剥除自动角膜内皮移植术（DSAEK）后的植片脱离率。
对2019年至2023年期间进行的265例手术（240例患者）的植片脱离率进行回顾性研究。DSAEK植片要么是手术医生切割的（n = 135），要么是预切割的并在含右旋糖酐的介质中运输（n = 82）或在不含右旋糖酐的介质中运输（n = 48）。所有手术均由同一位外科医生（I.G.）进行。根据接受者的眼睛是否具有与植片脱离风险增加相关的因素对手术进行分类。比较所有接受不同类型植片的患者的脱离率，以及仅那些没有风险因素的患者的脱离率。
对于所有接受者（包括有和没有植片脱离风险因素的），与手术医生切割的植片（14.1%，p = 0.002）和在不含右旋糖酐的介质中运输的预切割植片（6.3%，p = 0.002）相比，在含右旋糖酐的介质中运输的预切割植片的患者中发现脱离率显著更高（32.9%）。当分析没有植片脱离风险因素的接受者时，与手术医生切割的组织（8.3%，p = 0.002）和在不含右旋糖酐的介质中运输的预切割组织（3.6%，p = 0.01）相比，在含右旋糖酐的介质中运输的预切割组织的脱离率仍然显著更高（26.9%）。
使用在含右旋糖酐的介质中运输的预切割DSAEK组织会显著增加需要再次注入气泡的植片脱离风险。
