Eye (Lond):内皮自动剥离的角膜移植手术对虹膜角膜内皮综合征治疗的18例临床疗效

2017-12-18 cuiguizhong MedSci原创

北京大学第三医院眼科的Ao M近日在Eye (Lond)发表了他们的一项工作,他们对通过Descemet自动剥离内皮角膜移植手术(DSAEK)治疗虹膜角膜内皮(ICE)综合征的临床疗效进行了研究。

北京大学第三医院眼科的Ao M近日在Eye (Lond)发表了他们的一项工作,他们对通过Descemet自动剥离内皮角膜移植手术(DSAEK)治疗虹膜角膜内皮(ICE)综合征的临床疗效进行了研究。

他们进行了回顾性病例系列研究。在中国20例DSAEK移植患者中选取18例患者入组。与入组患者进行了前段光学相干断层扫描和共聚焦显微镜等检测。对术后并发症、移植物存活率、内皮细胞数目、角膜厚度和前房深度等进行分析。采用Kaplan-Meier分析的Log-rank检验和Cox比例风险回归分析等方法来分析移植失败的潜在危险因素。

入组患者的平均随访时间为19.0±8.6个月。在第1、3、6、12、18和24个月时,入组患者的内皮细胞密度(ECD)(细胞/ mm 2)值分别为3342.2±287.0、1897.6±745.4、1793.6±755.7、1618.1±604.3、1421.9±650.8、1265.1±844.1和1148.2±1217.8。其中,在20例移植手术中有11例显示继发性移植失败,平均移植物存活时间为23.4个月。在移植失败的眼中更容易术后立即出现并发症(气泡通气导致眼压升高或移植物脱离再次复发)(P = 0.040)。在手术后进行青光眼手术,是移植失败的危险因素,风险比为5.174。预后较差的患者表现为,1个月时中央角膜厚度增加,3个月后移植物厚度增加,6和12个月时前房深度增加。

因此,他们认为,Descemet自动剥离内皮角膜移植手术(DSAEK)对治疗虹膜角膜内皮(ICE)综合征的长期疗效较差。术后立即出现的并发症、角膜移植术后出现的青光眼、较厚的角膜参数和前房深度增加都与移植失败有关。

原文出处:

Ao, M., et al., Clinical outcome of Descemet stripping automated endothelial keratoplasty in 18 cases with iridocorneal endothelial syndrome. Eye (Lond), 2017.

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10:36:52 CST 2017, time=2017-12-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=270575, encodeId=2c6a2e057590, content=henhao, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/0, createdBy=508e2136543, createdName=太上老君1968, createdTime=Tue Dec 19 09:55:29 CST 2017, time=2017-12-19, status=1, ipAttribution=)]
    2017-12-24 半夏微凉

    学习了谢谢分享

    0

  5. 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target=_blank style='color:#2F92EE;'>#角膜移植#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=90973, encryptionId=da41909e3a6, topicName=角膜移植)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f3817754797, createdName=zhangj7114, createdTime=Wed Dec 20 14:00:00 CST 2017, time=2017-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431046, encodeId=74e614310469f, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=15, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Wed Dec 20 14:00:00 CST 2017, time=2017-12-20, status=1, ipAttribution=), 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10:36:52 CST 2017, time=2017-12-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=270575, encodeId=2c6a2e057590, content=henhao, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/0, createdBy=508e2136543, createdName=太上老君1968, createdTime=Tue Dec 19 09:55:29 CST 2017, time=2017-12-19, status=1, ipAttribution=)]
    2017-12-21 haige

    学习新知识。

    0

  6. 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  8. 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  9. 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10:36:52 CST 2017, time=2017-12-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=270575, encodeId=2c6a2e057590, content=henhao, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/0, createdBy=508e2136543, createdName=太上老君1968, createdTime=Tue Dec 19 09:55:29 CST 2017, time=2017-12-19, status=1, ipAttribution=)]
    2017-12-19 Y—xianghai

    学习了新知识

    0

  10. 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    2017-12-19 太上老君1968

    henhao

    0