Comparative Evaluation of Use of 400-&mgr;m and 350-&mgr;m Microkeratome Head to Prepare Donor Tissue in Cases of Descemet Stripping Automated Endothelial Keratoplasty

S. Jain, N. Sharma, P. Maharana, T. Agarwal, R. Sinha, R. Vajpayee
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引用次数: 5

Abstract

Purpose: To compare the outcomes of 400-&mgr;m microkeratome head with 350-&mgr;m microkeratome head Descemet stripping automated endothelial keratoplasty (DSAEK) in a prospective comparative study. Methods: Twenty cases of pseudophakic bullous keratopathy were randomly allocated into two groups. Group 1 underwent slow, single-pass 400-&mgr;m microkeratome head, whereas group 2 underwent the standard technique of DSAEK using a 350-&mgr;m microkeratome head. The primary outcome measures were best-corrected visual acuity (BCVA) at 6 months. Results: Groups were comparable in baseline characteristics. The mean central graft thickness (GT) at 6 months in group 1 was significantly thinner than group 2 (90.44±28.67 vs. 165.60±62.74 &mgr;m; P=0.003). The BCVA and contrast sensitivity were significantly better in group 1 than in group 2 (BCVA: 0.34±0.15 vs. 0.53±0.19 logMAR units, P=0.02; contrast sensitivity: 1.48±0.13 vs. 1.06±0.22, P=0.001). A significant correlation was found between both postoperative BCVA and contrast sensitivity, with the postoperative GT using Spearman rho correlation analysis (R=0.534, P=0.01 for BCVA and R=−0.522, P=0.02 for contrast sensitivity). The percentage endothelial cell loss was comparable between the 2 groups at the last follow-up (P=0.3). No major complications were observed during the study period. Conclusions: The use of a 400-&mgr;m microkeratome head instead of 350-&mgr;m head can improve the visual outcomes in DSAEK without increasing the risk of complications. The thickness of the DSAEK graft can affect the visual acuity and contrast sensitivity.
400- m和350- m微角化头在角膜内皮剥离自动角膜移植术中制备供体组织的比较评价
目的:在一项前瞻性比较研究中,比较400 μ m微角化头和350 μ m微角化头角膜剥离自动内皮角膜移植术(DSAEK)的结果。方法:将20例假性晶状体大疱性角膜病变随机分为两组。组1采用慢速单次400 μ m微角化头,组2采用标准DSAEK技术,使用350 μ m微角化头。主要结局指标为6个月时最佳矫正视力(BCVA)。结果:各组在基线特征上具有可比性。6个月时,组1的平均中心移植物厚度(GT)明显薄于组2(90.44±28.67∶165.60±62.74;P = 0.003)。组1的BCVA和对比敏感度显著优于组2 (BCVA: 0.34±0.15比0.53±0.19 logMAR单位,P=0.02;对比敏感度:1.48±0.13比1.06±0.22,P=0.001)。术后BCVA与对比敏感度存在显著相关性,术后GT采用Spearman rho相关分析(BCVA R=0.534, P=0.01,对比敏感度R= - 0.522, P=0.02)。在最后一次随访时,两组之间内皮细胞损失百分比具有可比性(P=0.3)。研究期间未见重大并发症。结论:用400 μ m微角化头代替350 μ m微角化头可改善DSAEK患者的视力,且不增加并发症的发生风险。DSAEK移植物的厚度会影响视力和对比敏感度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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