Descemet stripping automated endothelial keratoplasty in phakic eyes:incision modification reducing cataract formation

作     者：Jacqueline Beltz Silvana Madi Yoav Nahum Paolo Santorum Massimo Busin 

作者机构：Department of OphthalmologyVilla Igea Private HospitalForli 47122Italy Istituto Internazionale per la Ricerca e Formazione in Of talmologia(IRFO)Forli 47122Italy Department of MorphologySurgery and ExperimentalSurgeryUniversity of FerraraFerrara 44100Italy Centre for Eye Research AustraliaRoyal Victorian Eye and Ear HospitalMelbourne 3002Australia Department of OphthalmologyAlexandria University HospitalAlexandria 21527Egypt Department of OphthalmologyRabin Medical CenterPetahTikva 49100Israel Sackler Faculty of MedicineTel Aviv UniversityTel Aviv 69978Israel Department of OphthalmologySan Maurizio Regional HospitalBolzano 39100Italy 

出 版 物：《International Journal of Ophthalmology(English edition)》 (国际眼科杂志（英文版）)

年 卷 期：2018年第11卷第1期

页      面：53-57页

核心收录：

学科分类：1002[医学-临床医学] 100212[医学-眼科学] 10[医学] 

主　　题：cornea Descemet stripping automated endothelial keratoplasty cataract lamellar keratoplasty 

摘      要：AIM： To evaluate the efficacy of a technical modification to reduce the incidence of traumatic cataract induced by Descemet stripping automated endothelial keratoplasty（DSAEK） performed in phakic eyes. METHODS： A retrospective cohort study. The records of all patients with a clear crystalline lens and endothelial failure that underwent modified DSAEK at our insitution were reviewed. In this modification, in order to avoid inadvertent touch of the insertion forceps against the exposed crystalline lens while passing across the anterior chamber, the incision sites were shifted from the standard 9 and 3 o＇clock positions, superiorly to the 10 and 2 o＇clock position respectively. Formation of typically traumatic, anterior subcapsular cataract in these patients was compared to that observed in a cohort including all the patients with a clear crystalline lens and endothelial failure that underwent conventional DSAEK at our institution.RESULTS： The study group included 49 eyes following modified DSAEK and the control group included 35 eyes following DSAEK with conventional incision sites. Anterior subcapsular cataract occurring 4 mo or less postoperatively was identified in 2 of 49（4%） eyes in the study group and 7 of 35（20%） eyes in the control group. The rates of traumatic cataract were significantly higher in the control group in comparison to the study group（P=0.03, RR=4.9, 95%CI 1.08-22.1）.CONCLUSION： Traumatic cataract formation following phakic DSAEK may be avoided with a simple modification to the position of the incision sites.