偏离中心的 DMEK 移植物:影响和解决方案。

IF 1.9 3区 医学 Q2 OPHTHALMOLOGY
Vito Romano, Matteo Airaldi, Davide Romano, Francesco Miglio, Alfredo Borgia, Mohit Parekh, Francesco Semeraro, Nicolas Cesário Pereira
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引用次数: 0

摘要

目的:本研究旨在评估偏离中心的去角膜内皮角膜移植术(DMEK)与去角膜边缘移植术相比的效果:这是一项回顾性病例系列研究,研究对象是2022年6月至2023年7月期间进行的DMEK手术,术后出现移植物偏位,其特征是移植物与脱膜边缘之间存在间隙:结果:8 名患者的 8 只眼睛符合纳入标准。脱膜边缘与 DMEK 移植体之间的平均间隙为 911.2 μm(范围为 306-1468)。在所有病例中,间隙上产生的局灶性周边水肿均已消退,中位时间为 3 个月。最佳矫正视力从最小分辨角的对数 0.49(±0.26)提高到 12 个月时最小分辨角的对数 0.01(±0.02)(P = 0.003)。中心角膜厚度从 646.5 (±177.8) μm 降至 12 个月时的 473.7 (±29.6) μm(P = 0.05)。有一只眼睛在宿主-供体Descemet膜重叠区域出现了小范围的部分移植物脱离,脱离面积不到移植物表面积的三分之一。没有一只眼睛需要移植物重新灌注。去角膜缘与 DMEK 之间的间隙越大,修复时间越长(P = 0.06)。与鼻侧位置相比,下鼻翼周边的局灶性水肿恢复时间更长(P = 0.01)。较大的去角膜对DMEK间隙对纵向视力趋势没有显著影响(P = 0.75):去中心 DMEK 的特点是移植物和去角膜边缘之间存在间隙,会导致局灶性基质水肿,这种水肿会随着时间的推移而减轻,但对最终视力没有影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Off-Centered DMEK Grafts: Impact and Resolution.

Purpose: The aim of this study was to assess the outcomes of off-centered Descemet membrane endothelial keratoplasty (DMEK) grafts compared to descemetorhexis.

Methods: This is a retrospective case series of DMEK procedures conducted between June 2022 and July 2023 with postoperative graft decentration, characterized by a gap between the graft and descemetorhexis edge.

Results: Eight eyes of 8 patients met the inclusion criteria. The average gap between the descemetorhexis edge and DMEK graft was 911.2 μm (range 306-1468). The resulting focal peripheral edema overlying the gap resolved in all cases, with a median time of 3 months. Best-corrected visual acuity improved from 0.49 (±0.26) logarithm of the minimum angle of resolution to 0.01 (±0.02) logarithm of the minimum angle of resolution at 12 months (P = 0.003). Central corneal thickness decreased from 646.5 (±177.8) μm to 473.7 (±29.6) μm at 12 months (P = 0.05). One eye, in the overlapped area of host-donor Descemet membranes, had small peripheral partial graft detachment less than one-third of graft surface area. No eyes required graft rebubbling. A larger descemetorhexis to DMEK gap showed a trend toward longer resolution times (P = 0.06). Focal edema in the inferonasal periphery took longer to recover compared with the nasal position (P = 0.01). Larger descemetorhexis to DMEK gaps did not significantly influence the longitudinal visual acuity trend (P = 0.75).

Conclusions: Decentered DMEK, characterized by a gap between the graft and descemetorhexis edge, leads to focal stromal edema that diminishes over time, with no impact on final visual acuity.

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来源期刊
Cornea
Cornea 医学-眼科学
CiteScore
5.20
自引率
10.70%
发文量
354
审稿时长
3-6 weeks
期刊介绍: For corneal specialists and for all general ophthalmologists with an interest in this exciting subspecialty, Cornea brings together the latest clinical and basic research on the cornea and the anterior segment of the eye. Each volume is peer-reviewed by Cornea''s board of world-renowned experts and fully indexed in archival format. Your subscription brings you the latest developments in your field and a growing library of valuable professional references. Sponsored by The Cornea Society which was founded as the Castroviejo Cornea Society in 1975.
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