Mohamed Bahgat Goweida, Mohamed Aly Kolaib, Wael Abdel Rahman Elmenawy, Ahmed Shalaby Bardan
{"title":"不同泡型深度前板层角膜移植术治疗黄斑角膜营养不良的视力及屈光效果。","authors":"Mohamed Bahgat Goweida, Mohamed Aly Kolaib, Wael Abdel Rahman Elmenawy, Ahmed Shalaby Bardan","doi":"10.4103/joco.joco_226_24","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To determine the variations in deep anterior lamellar keratoplasty (DALK) techniques in eyes with macular corneal dystrophy (MCD), and to compare visual outcomes between standard DALK and Descemet's membrane (DM) baring DALK.</p><p><strong>Methods: </strong>A retrospective comparative case series was conducted, categorizing eyes into two groups: Group A, without DM baring, and Group B, with central DM baring. All DALK surgeries for MCD conducted between January 2010 and August 2020 at our institution were included in this study.</p><p><strong>Results: </strong>The study comprised 29 eyes from 18 patients with a mean follow-up period of 54.85 months. Type 1 bubble was achieved in 4 eyes (13.8%), type 2 or mixed bubbles were formed in 19 eyes (65.5%), and failed big bubble formation occurred in 6 eyes (20.7%). Group A (non-DM baring) comprised 18 eyes (62.1%), while Group B (central DM baring) included 11 eyes (37.9%). No statistically significant differences were found between the groups in terms of best-corrected visual acuity, spherical equivalent, or topographic astigmatism. However, Group B demonstrated significantly improved contrast sensitivity (<i>P</i> < 0.01). Group A displayed persistent or recurrent MCD opacities in 11 eyes (73.3%), whereas none were observed in Group B, demonstrating a statistically significant difference (<i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>The incidence of type 2 or mixed bubbles in MCD cases is relatively high, facilitating central DM baring. In this series, central DM baring correlated with improved contrast sensitivity and prevented MCD opacities recurrence. Thus, it should be considered in all DALK cases for MCD if a type 2 bubble is formed.</p>","PeriodicalId":15423,"journal":{"name":"Journal of Current Ophthalmology","volume":"36 4","pages":"387-392"},"PeriodicalIF":0.9000,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487799/pdf/","citationCount":"0","resultStr":"{\"title\":\"Visual and Refractive Outcomes of Different Bubble Types in Deep Anterior Lamellar Keratoplasty for Macular Corneal Dystrophy.\",\"authors\":\"Mohamed Bahgat Goweida, Mohamed Aly Kolaib, Wael Abdel Rahman Elmenawy, Ahmed Shalaby Bardan\",\"doi\":\"10.4103/joco.joco_226_24\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To determine the variations in deep anterior lamellar keratoplasty (DALK) techniques in eyes with macular corneal dystrophy (MCD), and to compare visual outcomes between standard DALK and Descemet's membrane (DM) baring DALK.</p><p><strong>Methods: </strong>A retrospective comparative case series was conducted, categorizing eyes into two groups: Group A, without DM baring, and Group B, with central DM baring. All DALK surgeries for MCD conducted between January 2010 and August 2020 at our institution were included in this study.</p><p><strong>Results: </strong>The study comprised 29 eyes from 18 patients with a mean follow-up period of 54.85 months. Type 1 bubble was achieved in 4 eyes (13.8%), type 2 or mixed bubbles were formed in 19 eyes (65.5%), and failed big bubble formation occurred in 6 eyes (20.7%). Group A (non-DM baring) comprised 18 eyes (62.1%), while Group B (central DM baring) included 11 eyes (37.9%). No statistically significant differences were found between the groups in terms of best-corrected visual acuity, spherical equivalent, or topographic astigmatism. However, Group B demonstrated significantly improved contrast sensitivity (<i>P</i> < 0.01). Group A displayed persistent or recurrent MCD opacities in 11 eyes (73.3%), whereas none were observed in Group B, demonstrating a statistically significant difference (<i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>The incidence of type 2 or mixed bubbles in MCD cases is relatively high, facilitating central DM baring. In this series, central DM baring correlated with improved contrast sensitivity and prevented MCD opacities recurrence. Thus, it should be considered in all DALK cases for MCD if a type 2 bubble is formed.</p>\",\"PeriodicalId\":15423,\"journal\":{\"name\":\"Journal of Current Ophthalmology\",\"volume\":\"36 4\",\"pages\":\"387-392\"},\"PeriodicalIF\":0.9000,\"publicationDate\":\"2025-09-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487799/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Current Ophthalmology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4103/joco.joco_226_24\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/10/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Current Ophthalmology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/joco.joco_226_24","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/10/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
Visual and Refractive Outcomes of Different Bubble Types in Deep Anterior Lamellar Keratoplasty for Macular Corneal Dystrophy.
Purpose: To determine the variations in deep anterior lamellar keratoplasty (DALK) techniques in eyes with macular corneal dystrophy (MCD), and to compare visual outcomes between standard DALK and Descemet's membrane (DM) baring DALK.
Methods: A retrospective comparative case series was conducted, categorizing eyes into two groups: Group A, without DM baring, and Group B, with central DM baring. All DALK surgeries for MCD conducted between January 2010 and August 2020 at our institution were included in this study.
Results: The study comprised 29 eyes from 18 patients with a mean follow-up period of 54.85 months. Type 1 bubble was achieved in 4 eyes (13.8%), type 2 or mixed bubbles were formed in 19 eyes (65.5%), and failed big bubble formation occurred in 6 eyes (20.7%). Group A (non-DM baring) comprised 18 eyes (62.1%), while Group B (central DM baring) included 11 eyes (37.9%). No statistically significant differences were found between the groups in terms of best-corrected visual acuity, spherical equivalent, or topographic astigmatism. However, Group B demonstrated significantly improved contrast sensitivity (P < 0.01). Group A displayed persistent or recurrent MCD opacities in 11 eyes (73.3%), whereas none were observed in Group B, demonstrating a statistically significant difference (P < 0.001).
Conclusions: The incidence of type 2 or mixed bubbles in MCD cases is relatively high, facilitating central DM baring. In this series, central DM baring correlated with improved contrast sensitivity and prevented MCD opacities recurrence. Thus, it should be considered in all DALK cases for MCD if a type 2 bubble is formed.
期刊介绍:
Peer Review under the responsibility of Iranian Society of Ophthalmology Journal of Current Ophthalmology, the official publication of the Iranian Society of Ophthalmology, is a peer-reviewed, open-access, scientific journal that welcomes high quality original articles related to vision science and all fields of ophthalmology. Journal of Current Ophthalmology is the continuum of Iranian Journal of Ophthalmology published since 1969.