关键词: 角膜内皮移植, 后弹力层撕除角膜内皮移植, 大泡性角膜病变

Abstract:  Objective To observe the efficacy of simplified Descemet’s stripping endothelial keratoplasty (DSEK) in the treatment of complex bullous keratopathy. Design Retrospective case series. Participants 11 patients (11eyes) with complex bullous keratopathy have receipted keratoplasty in General Hospital of Northern Theater Command from December 2015 to August 2017. Methods All cases are treated with DSEK. The grafts were prepared with hand assisted method, and the average diameter was (8.05±0.57) mm. All grafts were implanted with a skateboard. Main Outcome Measures The adherence of the donor lenticule to the recipient posterior stroma and complications were monitored in the early stage after surgery. Best-corrected visual acuity (BCVA), corneal astigmatism, graft transparency and thickness, endothelial cell density (ECD) and surgical complications were recorded in 1 year after surgery. Results In all 11 eyes, 8 donor lenticules were well adherence to the recipient posterior stroma and 3 graft dislocations occurred at the early postoperative term. One eye was diagnosed with secondary open-angle glaucoma at the postoperative 4 month. Postoperative BCVA was 0.3 or more in 7 eyes, and mean corneal astigmatism was (1.83±0.46) D. All grafts kept clearance during 1 year follow-up period, and the average graft thickness was (126±19) μm. No immune rejection episodes were recorded. The average ECD was (954±218）/mm2. Conclusion Although the DSEK for complex bullous keratopathy are relative difficulty, it can obtain satisfactory efficacy. (Ophthalmol CHN, 2020, 29: 38-42)

Key words: endothelial keratoplasty, Descemet’s stripping endothelial keratoplasty, bullous keratopathy