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首页> 外文期刊>Cornea >Incidence of early allograft rejection after Descemet membrane endothelial keratoplasty.
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Incidence of early allograft rejection after Descemet membrane endothelial keratoplasty.

机译：Descemet膜内皮角膜移植术后异体移植早期排斥反应的发生率。

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PURPOSE: To report the incidence of early allograft rejection after Descemet membrane endothelial keratoplasty (DMEK), that is, transplantation of isolated Descemet membrane with its endothelium. METHODS: The first series of 120 eyes of 105 patients operated on for Fuchs endothelial dystrophy or pseudophakic bullous keratopathy, with an average 2 years of follow-up after 9.0- to 10.0-mm-diameter DMEK, enrolled in our study. RESULTS: During the entire study period, only 1 of the eyes showed any signs of a cellular immune response to the Descemet graft. A 76-year-old patient presented with discomfort, reduced visual acuity to counting fingers, corneal decompensation, and a Khodadoust line in the central cornea 4 months after (decentered) DMEK. Intensified topical corticoid therapy resulted in a complete visual recovery to 20/25 (0.8) within weeks. CONCLUSIONS: A "classic" allograft rejection (with an appearance similar to that after penetrating keratoplasty) can occur after DMEK. However, compared with the earlier (endothelial) keratoplasty procedures, DMEK may be associated with a lower rejection rate of
机译：目的：报道在Descemet膜内皮角膜移植术（DMEK）后，即分离的Descemet膜及其内皮移植后，早期同种异体移植排斥反应的发生率。方法：本研究纳入了105例因Fuchs内皮营养不良或假性晶状体大疱性角膜病变而手术的第一眼，共120眼，平均直径9.0至10.0毫米DMEK术后平均随访2年。结果：在整个研究过程中，只有一只眼睛对Descemet移植物表现出任何细胞免疫反应的迹象。 DMEK（偏心）术后4个月，一名76岁患者出现不适，手指数数视力下降，角膜代偿不足以及角膜中央的Khodadoust线。强化局部皮质激素治疗可在几周内使视力完全恢复至20/25（0.8）。结论：DMEK后可能发生“经典”同种异体移植排斥反应（外观与穿透性角膜移植术后相似）。但是，与较早的（内皮）角膜移植术相比，尽管移植物直径为+/- 9.5 mm，但DMEK的排斥率可能较低，≤1％。 DMEK中明显的免疫耐受性可能是由于免疫系统的较少“上调”或较多“下调”引起的。

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