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| [PMID]: | 28742617 |
| [Au] Autor: | Dimitry MES; Lewis AD; Zacharaki F; Chandran M; Robson D; Menon G; Poole TRG |
| [Ad] Endereço: | The Eye Dept, Frimley Park Hospital, Frimley Health NHS Foundation Trust, Surrey, United Kingdom. |
| [Ti] Título: | Simple Single-Pass Technique for Ultrathin Descemet Stripping Automated Endothelial Keratoplasty: A Pilot Study. |
| [So] Source: | Cornea;36(10):1178-1183, 2017 Oct. | | [Is] ISSN: | 1536-4798 |
| [Cp] País de publicação: | United States |
| [La] Idioma: | eng |
| [Ab] Resumo: | PURPOSE: To assess intraoperative and postoperative graft thickness (GT) after donor deturgescence for ultrathin Descemet stripping automated endothelial keratoplasty and to evaluate visual outcomes, endothelial cell density, and patient satisfaction at 1 year. METHODS: Prospective interventional case series of patients with Fuchs endothelial dystrophy, Fuchs endothelial dystrophy and cataract, and pseudophakic bullous keratopathy (n = 12 grafts). The donor cornea was allowed to thin out by simple evaporation on an artificial anterior chamber, to the required precut thickness, before a single microkeratome pass. GT after microkeratome cut, at 1 week, 1, 3, 6, and 12, months was measured. Early Treatment Diabetic Retinopathy Study (ETDRS) best-corrected visual acuity, Pelli-Robson contrast sensitivity, endothelial cell density, and score on the visual function questionnaire (VFQ-25) were assessed. RESULTS: Mean intraoperative postmicrokeratome cut GT was 78.9 ± 33.3 µm. Mean GT at 1 week, 1, 3, 6, and 12 months was 70.7, 70.9, 62.8, 66.5, and 58.9 µm, respectively. Mean initial donor corneal thickness was 647 ± 67 µm, and mean precut thickness was 526 ± 4.5 µm (mean thinning time: 17 min). Best-corrected visual acuity at 1 week, 1, 3, 6, and 12 months was 68.8, 76.9, 76.3, 76.9, and 78.6 letters with 9-letter gain at 12 months (P = 0.02). Mean endothelial cell loss at 3, 6, and 12 months was 36.8% ± 6.75%, 37.2% ± 8%, and 37.9% ± 9.75% loss, respectively. At 1 year, 83.3% of patients achieved ≥20/40 (6/12) and 66.7% of patients achieved ≥20/32 (6/9.5). VFQ-25 testing showed an improvement in the visual function. CONCLUSIONS: This pilot study demonstrates a simple graft deturgescence technique that reproducibly creates ultrathin grafts without donor wastage. |
| [Mh] Termos MeSH primário: |
Ceratoplastia Endotelial com Remoção da Lâmina Limitante Posterior/métodos
Distrofia Endotelial de Fuchs/cirurgia
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| [Mh] Termos MeSH secundário: |
Idoso
Sensibilidades de Contraste/fisiologia
Paquimetria Corneana
Epitélio Posterior/patologia
Epitélio Posterior/transplante
Feminino
Seres Humanos
Período Intraoperatório
Masculino
Meia-Idade
Projetos Piloto
Período Pós-Operatório
Estudos Prospectivos
Doadores de Tecidos
Tomografia de Coerência Óptica
Acuidade Visual/fisiologia
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| [Pt] Tipo de publicação: | JOURNAL ARTICLE |
| [Em] Mês de entrada: | 1802 |
| [Cu] Atualização por classe: | 180209 |
[Lr] Data última revisão:
| 180209 |
| [Sb] Subgrupo de revista: | IM |
| [Da] Data de entrada para processamento: | 170726 |
| [St] Status: | MEDLINE |
| [do] DOI: | 10.1097/ICO.0000000000001273 |
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