角膜内皮营养不良合并白内障合并老花眼人工晶状体白内障手术后行内皮膜角膜移植术。

IF 2.1 3区医学 Q2 OPHTHALMOLOGY

Japanese Journal of Ophthalmology Pub Date : 2025-05-26 DOI:10.1007/s10384-025-01215-1

Hideaki Yokogawa, Takahiko Hayashi, Akira Kobayashi, Natsuko Mori, Kenichiro Yamazaki, Hirohito Ohta, Masato Takeda, Ami Igarashi, Satoru Yamagami

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引用次数: 0

摘要

目的：评价合并Fuchs角膜内皮营养不良（FECD）合并白内障患者植入术后分阶段行角膜内皮成形术（DMEK）的疗效。方法：我们纳入了3例同时患有FECD和白内障的患者（3名女性，年龄67.8±6.5岁），共6眼，接受了老花眼矫正人工晶体植入术，随后进行了DMEK治疗。分析改良Krachmer分级、视力结果、术中及术后并发症的发生率。结果：改良Krachmer FECD评分为1、2、3眼分别为4、5、6级。原发性老花眼矫正人工晶状体的平均最佳矫正视力（BCVA）不满意（十进制0.45），DMEK后的最佳矫正视力（BCVA）明显改善（十进制1.0,P = 0.027），所有眼睛均获得满意的未矫正距离和近（30 cm）视力（平均值，十进制，距离0.85和近0.56）。经DMEK处理后的显球当量在可接受范围内（-0.375 D ~ 0.0 D）。4只眼睛需要重新泡泡，但没有遇到其他术后并发症或原发性移植物失败的情况。结论：对于FECD合并白内障患者，DMEK分期植入术是一种可行的选择。

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Descemet membrane endothelial keratoplasty after cataract surgery with presbyopia-correcting intraocular lens for coexisting Fuchs endothelial corneal dystrophy and cataract.

Purpose: To assess the outcomes of Descemet membrane endothelial keratoplasty (DMEK) staged after implantation of presbyopia-correcting intraocular lenses (IOLs) in patients with coexisting Fuchs endothelial corneal dystrophy (FECD) and cataract.

Study design: Retrospective, interventional case series METHODS: We enrolled six eyes of three patients with coexisting FECD and cataract (3 women, age 67.8 ± 6.5 years) treated with presbyopia-correcting IOL implantation, followed by DMEK. The modified Krachmer grade, visual outcomes, and incidence of intra- and postoperative complications were analyzed.

Results: Modified Krachmer FECD grades 4, 5, and 6 were observed in one, two, and three eyes, respectively. The mean best-corrected visual acuity (BCVA) was dissatisfactory with the primary presbyopia-correcting IOL (decimal 0.45), it improved significantly (decimal 1.0, P = 0.027) after DMEK and all eyes acquired satisfactory uncorrected distance and near (30 cm) vision (mean, decimal, distance 0.85 and near 0.56). The manifest spherical equivalent after DMEK was within the acceptable range (-0.375 D to 0.0 D). Rebubbling was required in four eyes, but no instances of other postoperative complications or primary graft failure were encountered.

Conclusion: DMEK staged after implantation of presbyopia-correcting IOLs is a viable option for patients with coexisting FECD and cataract.

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来源期刊

Japanese Journal of Ophthalmology 医学-眼科学

CiteScore

4.80

自引率

8.30%

发文量

审稿时长

6-12 weeks

期刊介绍： The Japanese Journal of Ophthalmology (JJO) was inaugurated in 1957 as a quarterly journal published in English by the Ophthalmology Department of the University of Tokyo, with the aim of disseminating the achievements of Japanese ophthalmologists worldwide. JJO remains the only Japanese ophthalmology journal published in English. In 1997, the Japanese Ophthalmological Society assumed the responsibility for publishing the Japanese Journal of Ophthalmology as its official English-language publication. Currently the journal is published bimonthly and accepts papers from authors worldwide. JJO has become an international interdisciplinary forum for the publication of basic science and clinical research papers.