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首页> 外文期刊>Cornea >Bimanual technique for insertion and positioning of endothelium-descemet membrane graft in descemet membrane endothelial keratoplasty
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Bimanual technique for insertion and positioning of endothelium-descemet membrane graft in descemet membrane endothelial keratoplasty

机译：用于插入膜内皮角落成形术中的内皮膜移植物插入和定位的生物化技术

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摘要

PURPOSE:: To describe a new bimanual technique for insertion and positioning of endothelium-Descemet membrane (EDM) grafts in Descemet membrane endothelial keratoplasty (DMEK). METHODS:: Prospective, noncomparative, consecutive interventional case series, including 15 pseudophakic eyes of 15 patients treated with DMEK at the Instituto de Microcirugia Ocular, Barcelona, Spain. A bimanual infusion technique was used to introduce and position donor's EDM. Partial tamponade was achieved with 20% sulfur hexafluoride (SF6). Intraocular manipulation time of EDM grafts, rebubbling rate, and endothelial cell density were evaluated. RESULTS:: Six months postoperatively, mean uncorrected visual acuity and best spectacle-corrected visual acuity (BSCVA) improved from 20/100 to 20/50 and from 20/80 to 20/25, respectively (P < 0.001). Six eyes (40%) had ≥20/20 BSCVA, and 13 (86%) eyes had ≥20/30 BSCVA. Mean donor cell density decreased from 2690 ± 302 to 1998 ± 621 cells per square millimeter, representing a mean cell loss of 26% ± 20%. EDM was stripped successfully in all cases. Mean intraocular manipulation time of donor's EDM (interval between main incision closure and final EDM positioning) was 4.10 ± 0.5 minutes. Intracameral air reinjection was needed in 1 case (6.6%) with a partial peripheral graft detachment. No episodes of immunologic graft rejection were documented. CONCLUSIONS:: Insertion and positioning of EDM grafts in DMEK was successfully achieved using this bimanual infusion technique and 20% SF6 partial tamponade, with a low intraocular manipulation time and very low postoperative rebubbling rates, regardless of the preservation method and the donor's age. However, prospective comparative studies are required to demonstrate the long-term safety compared with other approaches.
机译：目的::描述一种新的生物化技术，用于插入和定位内皮膜内皮角膜形术（DMEK）中的内皮 - 去皮膜（EDM）移植物。方法::前瞻性，非渗透，连续的介入案例系列，包括15名患者的15名患者，在Instituto de Microcirugia Ocular，Barcelona，西班牙治疗。使用了一种生理的输注技术来引入和定位供体的EDM。用20％六氟化硫化物（SF6）实现部分局部局部局部局部局部局部局部局部局部局部局部局部。评估EDM移植物，伸缩率和内皮细胞密度的眼内操纵时间。结果::六个月术后，平均未经校正的视力和最佳景观校正的视力（BSCVA）分别从20/100到20/50增加到20/80到20/25（P <0.001）。六只眼（40％）≥20/ 20 bscva，13（86％）眼睛≥20/ 30 bscva。平均供体细胞密度从2690±302至1998±621个细胞每平方毫米降低，表示平均细胞损失为26％±20％。 EDM在所有情况下成功剥离。供体的EDM的平均眼内操纵时间（主切口闭合和最终EDM定位之间的间隔）为4.10±0.5分钟。在1例（6.6％）中需要胞内的空气再注，其中部分外周接枝脱离。没有记录免疫接枝抑制的剧集。结论::使用这种生理输液技术和20％SF6部分局部局部局部局部局部裁员成功地实现了DMEK中EDM移植物的插入和定位，具有低的眼内操作时间和非常低的术后重压率，无论保存方法和捐助者的年龄如何。然而，与其他方法相比，需要前瞻性的比较研究来证明长期安全性。

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