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Femtosecond laser-assisted Descemeta??s stripping endothelial keratoplasty: a prospective study of 6-month visual outcomes, corneal thickness and endothelial cell loss
摘要： Purpose To report 6-month outcomes of visual acuity, the corneal thickness and endothelial cell density (ECD) in patients undergoing femtosecond laser-assisted Descemet’s stripping endothelial keratoplasty (FS-DSEK). Methods This prospective, consecutive, interventional series examined 25 eyes of 25 patients who underwent FS-DSEK for Fuchs endothelial dystrophy and bullous keratopathy. The pre-cut endothelial graft thickness (CET) was 150 lm. Best-corrected visual acuity (BCVA), central corneal thickness (CCT), donor CET, recipient corneal stromal thickness (CST) and ECD were assessed at 1 week and 1, 2, 3 and 6 months postoperatively. Results The mean BCVA at 6 months was 0.76 ± 0.35 logMAR units, improving from 1.54 ± 0.52 logMAR. CCT decreased significantly, from 759.8 ± 152.4 lm at 1 week to 631.7 ± 79.7 lm at 6 months postoperatively (P = 0.001). CET recovered to 153.4 ± 33.7 lm (P = 0.076) at 6 months as pre-cut status. The CST decreased from 561.5 ± 96.3 lm at 1 week to 479.7 ± 57.9 lm at 6 months (P < 0.001). Preoperatively, the donor ECD was 2747.6 ± 255.4 cells/mm2, and the ECD decreased to 1729.1 ± 562.9 cells/mm2 at 6 months, for a peak ECD loss of 36.86%. A greater decrease in CST observed from 1 week to 6 months postoperatively correlated with a lower ECD loss (P = 0.019) and a lower preoperative ECD (P = 0.012). However, a thinner CET correlated with a higher preoperative ECD (P = 0.028). Conclusions FS-DSEK is a safe and effective surgical alternative for corneal endothelial decompensation. The donor ECD and its changes could be used as predictive factors for the improvement of CST and CET.
关键词： Visual acuity,Corneal endothelial cell density,Graft thickness,Femtosecond laser,Descemet’s stripping endothelial keratoplasty
更新于2025-09-23 15:19:57
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Corneal Endothelium Changes 6 Months after Laser Peripheral Iridotomy: Prospective Study
摘要： A decrease in corneal endothelial cell density (ECD) after laser peripheral iridotomy (LPI) has been reported to varying degrees, whereas some investigations have demonstrated no change. Endothelial cell loss after LPI has been hypothesized to result from excessive heat production during the iris photovaporization (Argon) or photodisruption (neodymium:yttriumealuminumegarnet) processes. In our prospective study, we examined the impact of LPI on ECD, comparing ECD before LPI with that 6 months after LPI. Patients 30 years of age or older who were diagnosed as primary angle-closure suspect (PACS) or with primary angle closure (PAC) or primary angle-closure glaucoma (PACG) in at least 1 eye were recruited between September 2012 and December 2013 from glaucoma clinics at Aravind Eye Hospitals in Coimbatore and Pondicherry, South India. The Aravind Eye Hospitals Institutional Review Board approved the study protocol, and written, informed consent was obtained from all participants. The study adhered to the tenents of the Declaration of Helsinki. Exclusion criteria were (1) bilateral pseudophakia, (2) symptoms or signs of acute angle closure attack, or (3) prior iridotomy, iridoplasty, or incisional glaucoma surgery.
关键词： Laser Peripheral Iridotomy,Primary Angle-Closure Glaucoma,Primary Angle-Closure Suspect,Endothelial Cell Density,Corneal Endothelium,Primary Angle Closure
更新于2025-09-19 17:13:59