Complex deep lamellar endothelial keratoplasty for complex bullous keratopathy with severe vision loss.

摘要: PURPOSE To determine the efficacy and postoperative complications of complex deep lamellar endothelial keratoplasty (DLEK) when used for management bullous keratopathy with severe vision loss. METHODS Twelve consecutive eyes other associated intraocular abnormalities underwent DLEK which was combined surgeries such as vitrectomy, lens removal, secondary implantation. An air bubble in 9 an C3F8 gas 3 tissue support. Prospective data best spectacle-corrected visual acuity, corneal astigmatism, curvature were collected on all 12 preoperatively at 6, 9, months postoperatively. Average donor cell density recorded RESULTS Preoperatively, loss hand motions (n = 3), count fingers 7), 20/400 2). Best acuity improved 83% 20/67 or better 42% (5/12) 20/100 66% (8/12) Vision not three due to coexistent retinal disease. Four aphakic implantation later 4-6 after DLEK, increased from 20/200 better. At postoperatively, average astigmatism 2.3 +/- 0.5 diopters 44.0 0.9 diopters, respectively. central thickness postoperatively (541.3 26.7 microm) significantly thinner than that before surgery (673.8 77.5 microm, P < 0.01). Preoperative 2685.1 193.9 cells/mm. 1920.1 94.0 cells/mm (27.3% loss) primary 1866.3 92.8 (33.9% surgery. Postoperative usually occurred within After surgery, showed narrow gaps between border graft host. Epithelial bullae these areas recurred 2 but disappeared months. There one dislocation this series, no pupillary block cases, failures. CONCLUSIONS In cases loss, is a feasible effective procedure improve functional level most patients. can be successfully aphakia anterior segment without high risk failure. Mild early did affect outcomes survival if managed appropriately.