Descemet Stripping Endothelial Keratoplasty—Rapid Recovery of Visual Acuity

摘要: The most frequent indications for corneal grafting include diseases of the endothelium, such as Fuchs endothelial dystrophy, bullous keratopathy, and failure following keratoplasty. dystrophy is a hereditary disorder endothelium that affects women more often than men advances through various stages over period years (1). First, central asymptomatic thickening (guttae) appears on Descemet membrane, basal membrane at inner surface cornea. As disease progresses there increasing edema, leading to light sensitivity blurred vision. This followed by subepithelial vesicle formation (bullous keratopathy); patient experiences severe pain when bullae burst. Finally stroma becomes fibrotic, with irreversible loss transparency. Among persons age 40 years, up 3.8% have cornea guttata 0.1% keratopathy (e1). There may be other causes including post-inflammatory, post-traumatic, or postoperative damage. Since these processes frequently involve inflammation pronounced cells, prognosis transplantation limited (2). The first procedure was carried out Eduard Zirn (3, 4) in 1905. so-called penetrating keratoplasty (PKP), which typically all five layers (epithelium, Bowman layer, stroma, endothelium) are transplanted (Figure 1a). Because only layer affected above-mentioned early 1956 Tillet (5) proposed replacing rear part (posterior lamellar keratoplasty). intended avoid some problems can occur after PKP, astigmatism wound healing disorders. Although technical principle operation could implemented, visual results proved unsatisfactory patients. Figure 1 Figure 1: Techniques