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Descemet stripping automated endothelial keratoplasty in phakic eyes:incision modification reducing cataract formation

查看全文 作　　者：Jacqueline [1,2,4]Beltz;Silvana [1,2,5]Madi;Yoav [1,2,6,7]Nahum;Paolo [1,2,8]Santorum;Massimo [1,2,3]Busin 高影响力作者 机构地区：[1]Department of Ophthalmology,Villa Igea Private Hospital,Forli 47122,Italy;[2]Istituto Internazionale per la Ricerca e Formazione in Of talmologia(IRFO),Forli 47122,Italy;[3]Department of Morphology,Surgery and ExperimentalSurgery,University of Ferrara,Ferrara 44100,Italy;[4]Centre for Eye Research Australia,Royal Victorian Eye and Ear Hospital,Melbourne 3002,Australia;[5]Department of Ophthalmology,Alexandria University Hospital,Alexandria 21527,Egypt;[6]Department of Ophthalmology,Rabin Medical Center,PetahTikva 49100,Israel;[7]Sackler Faculty of Medicine,Tel Aviv University,Tel Aviv 69978,Israel;[8]Department of Ophthalmology,San Maurizio Regional Hospital,Bolzano 39100,Italy高影响力机构 出　　处：《International Journal of Ophthalmology(English edition)》索引2018年第11卷第1期,共5页高影响力期刊 摘　　要：AIM: To evaluate the efficacy of a technical modification to reduce the incidence of traumatic cataract induced by Descemet stripping automated endothelial keratoplasty(DSAEK) performed in phakic eyes. METHODS: A retrospective cohort study. The records of all patients with a clear crystalline lens and endothelial failure that underwent modified DSAEK at our insitution were reviewed. In this modification, in order to avoid inadvertent touch of the insertion forceps against the exposed crystalline lens while passing across the anterior chamber, the incision sites were shifted from the standard 9 and 3 o'clock positions, superiorly to the 10 and 2 o'clock position respectively. Formation of typically traumatic, anterior subcapsular cataract in these patients was compared to that observed in a cohort including all the patients with a clear crystalline lens and endothelial failure that underwent conventional DSAEK at our institution.RESULTS: The study group included 49 eyes following modified DSAEK and the control group included 35 eyes following DSAEK with conventional incision sites. Anterior subcapsular cataract occurring 4 mo or less postoperatively was identified in 2 of 49(4%) eyes in the study group and 7 of 35(20%) eyes in the control group. The rates of traumatic cataract were significantly higher in the control group in comparison to the study group(P=0.03, RR=4.9, 95%CI 1.08-22.1).CONCLUSION: Traumatic cataract formation following phakic DSAEK may be avoided with a simple modification to the position of the incision sites. 关 键 词：角膜 脱衣的 Descemet 自动化了 endothelial keratoplasty 奔流 薄片状的 keratoplasty
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