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NR 7-9/2007
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Wyniki
keratoplastyki endotelialnej z zastosowaniem descemetoreksji (DSEK)
Outcomes of endothelial
keratoplasty with descemetorhexis (DSEK)
Edward Wylęgała1,2, Dorota
Tarnawska, Dariusz Dobrowolski, Dominika Janiszewska
1Z Zakładu Pielęgniarstwa i Społecznych Problemów
Medycznych Wydziału Opieki Zdrowotnej
¦l±skiej Akademii Medycznej w Katowicach
Kierownik: dr hab. n. med. Edward Wylęgała
2Z Oddziału Okulistycznego Okręgowego Szpitala
Kolejowego w Katowicach
Ordynator: dr hab. n. med. Edward Wylęgała |
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| Summary: |
Purpose: Analysis
of morphologic and functional outcomes of endothelial
keratoplasty with descemetorhexis technique for
recipient Descemet’s membrane removal (DSEK).
Material and methods: We analyzed patients
treated for chronic endothelial dysfunction with DSEK
technique. For the study 12 patients (12 eyes) with
follow up at least 9 months, were qualified. Study group
consisted of 9 women and 3 men, in age from 53 to 83
years, mean 72.9 ± 7.82 years. All surgery were
performed by one surgeon (EW). Anterior chamber was
opened through 5 mm wide and 3 mm long sclero–corneal
tunnel. Before descemetorhexis incision points on the
endothelial side of cornea were done with radio–frequency
diathermy. Descemet’s membrane stripping was done with
the forceps. Endothelial grafts were fixed with anterior
chamber by air tamponade. We analyzed postoperative
visual acuity (on Snellen’s charts), corneal
transparency, endothelial cell density, total central
corneal thickness and endothelial button (with OCT
Visante), and complications of the surgery.
Results: 9 months postoperatively VA ranged from
0.1 to 0.5 (mean 0.28 ± 0.15), BCVA ranged 0.1 – 0.9 (mean
0.43 ± 0,30). Endothelial cell density ranged from 982
to 2781 cells per square millimeter (mean 1848.5 ±
550.7). Total central corneal thickness ranged from 642
to 998 μm (mean 791.6 ± 38.0 μm) before surgery and from
536 to 789 μm (mean 645 ± 61.3 μm,) 12 months
postoperatively . Total central thickness of the
endothelial graft 12 months postoperatively ranged from
42 to 163 μm (mean 89.1 ± 38.2 μm). One penetrating
keratoplasty was made for graft failure. Due to
endothelial graft detachment
or dislocation in anterior chamber, air tamponade was
made in 5 cases with satisfactory final result.
Only one case of the rejection was observed.
Conclusions: Endothelial keratoplasty (DSEK) is
safe and effective procedure in treatment of the
endothelial cell dysfunction. Surgery supported by
descemetorhrexis is easy and quick and results in smooth
endothelial graft bed. The DSEK technique decreases
surgery time and number of corneal graft dislocations. |
| Słowa kluczowe: |
keratoplastyka warstwowa
tylna, descemetoreksja, DSEK. |
| Key words: |
posterior lamellar
keratoplasty, descemetorhexis, DSEK. |
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