Descemet Stripping Automated Endothelial Keratoplasty versus Descemet Membrane Endothelial Keratoplasty for Fuchs Endothelial Corneal Dystrophy
德塞梅膜剝離自動化內皮角膜移植術與德塞梅膜內皮角膜移植術治療福克斯內皮角膜病變的比較
| Created | |
|---|---|
| Tags | Cornea |
| Journal | Ophthalmology |
| Status | 審查完成 |
| 校稿者 | 蕭靜熹 醫師 |
Ophthalmology Volume 130, Number 12, December 2023
中文摘要
本研究納入了2012年至2019年間在瑞典角膜移植紀錄登記中完成2年追蹤的一千六百七十七名接受內皮角膜移植手術的患者。根據視力、年齡、性別、手術年份和手術前炎症、血管生成和青光眼等風險因素進行傾向評分匹配，形成了三個可比較的組別(DMEK、DSAEK和 phacoemulsification plus DSAEK)每組216名患者。主要結果指標為2年追蹤時的最佳矯正視力和移植物存活頻率。結果顯示，三種手術方法中大多數患者(90%)的視力都有所提升。然而，DMEK和phacoemulsification plus DSAEK在手術後2年的視力水平更高，而phacoemulsification plus DSAEK在移植物存活率方面更優。三種手術方法都有優點和缺點，選擇手術方法應個體化，考慮到不僅僅是角膜，還有每位患者的完整醫療狀況以及手術後的全程醫療。
English Abstract
The study included 1,677 patients who underwent endothelial keratoplasty in Sweden from 2012 to 2019. Three groups (DMEK, DSAEK, and phacoemulsification plu sDSAEK) were compared based on surgical method and propensity score matching. The main outcome measures were Best-corrected visual acuity (BCVA) at the 2-year follow-up, frequency of graft dislocation,graft rejection episodes,and graft failure within 2 years including primary graft failure. The study found that visual acuity improved in 90% of patients with all three surgical methods, but DMEK and phacoemulsification plus DSAEK had higher levels of visual acuity after 2 years. The frequency of graft dislocation was higher among the patients undergoing phacoemulsification plus DSAEK, but the frequency of graft failure and primary graft failure was higher in the DMEK group.The study suggests that the choice of surgical method should be individualized based on the patient’s complete medical status.
