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[PMID]: | 28742620 |
[Au] Autor: | Ampazas P; Droutsas K; Giallouros E; Schroeder FM; Sekundo W |
[Ad] Endereço: | *Department of Ophthalmology, Philipps University of Marburg, Marburg, Germany; and †First Department of Ophthalmology, National and Kapodistrian University of Athens-Faculty of Medicine, Athens, Greece. |
[Ti] Título: | Comparison of 5% Sulfur Hexafluoride Versus 100% Air Tamponade in Descemet Membrane Endothelial Keratoplasty. |
[So] Source: | Cornea;36(10):1189-1194, 2017 Oct. | [Is] ISSN: | 1536-4798 |
[Cp] País de publicação: | United States |
[La] Idioma: | eng |
[Ab] Resumo: | PURPOSE: To compare the rebubbling rate and clinical outcomes of Descemet membrane endothelial keratoplasty (DMEK) with 5% sulfur hexafluoride (SF6) gas versus 100% air as a tamponade for graft attachment. METHODS: Retrospective, comparative, interventional case series including 368 consecutive pseudophakic eyes with Fuchs endothelial dystrophy or pseudophakic bullous keratopathy that underwent DMEK in a tertiary referral center between October 2010 and August 2015 using either air (group 1, 191 eyes) or 5% SF6 (group 2, 177 eyes) as a tamponade. The rebubbling rate, complications, best-corrected distance visual acuity (BCVA), manifest refraction, and endothelial cell density were analyzed before and at 1 week, 1, 3, 6, 12, 24, and 36 months after surgery. RESULTS: The rebubbling rate was 20.4% (39/191, group 1) versus 6.8% (12/177, group 2; P < 0.001). Complications included cystoid macular edema (n = 5, group 1, and n = 10, group 2; P = 0.14) and 1 case of presumed allograft rejection (n = 1, group 2). The follow-up period was 12 ± 8 months for group 1 and 6 ± 4 months for group 2. BCVA (logarithm of the minimum angle of resolution) had improved after 12 months from 1.43 ± 0.63 to 0.18 ± 0.26 (group 1, P < 0.001) and from 1.8 ± 0.63 to 0.18 ± 0.17 (group 2, P < 0.001). The percentage of eyes with BCVA ≥0.2 logarithm of the minimum angle of resolution at 12 months was 70.9% (90/127, group 1) and 78.4% (40/51, group 2; P = 0.3). Endothelial cell loss at 12 months after DMEK was 44 ± 18% (group 1) versus 33 ± 15% (group 2, P = 0.07). CONCLUSIONS: The use of a tamponade with 5% SF6 yielded a significantly lower incidence of graft detachment requiring surgical reintervention with no detrimental effect on graft endothelial cells. Thus, routine use of 5% SF6 for a graft tamponade in DMEK is recommended. |
[Mh] Termos MeSH primário: |
Ar Perda de Células Endoteliais da Córnea/prevenção & controle Ceratoplastia Endotelial com Remoção da Lâmina Limitante Posterior Tamponamento Interno/métodos Rejeição de Enxerto/prevenção & controle Hexafluoreto de Enxofre/administração & dosagem Aderências Teciduais
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[Mh] Termos MeSH secundário: |
Idoso Contagem de Células Feminino Distrofia Endotelial de Fuchs/cirurgia Seres Humanos Masculino Refração Ocular/fisiologia Estudos Retrospectivos Doadores de Tecidos Acuidade Visual/fisiologia
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[Pt] Tipo de publicação: | COMPARATIVE STUDY; JOURNAL ARTICLE |
[Nm] Nome de substância:
| WS7LR3I1D6 (Sulfur Hexafluoride) |
[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.0000000000001299 |
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