펨토초 레이저를 이용한 데스메막박리 각막내피층판 이식술의 장기 임상경과 = Long-term Clinical Outcomes of Femtosecond LASER-Assisted Descemet’s Stripping Endothelial Keratoplasty

다국어 초록 (Multilingual Abstract)

Purpose: To evaluate the long-term clinical outcomes of femtosecond LASER-assisted Descemet’s stripping endothelial keratoplasty (DSEK). Methods: The clinical results of endothelial keratopathy from 11 consecutive patients who were followed up for at least 12 months after femtosecond LASER-assisted DSEK were retrospectively analyzed. The best corrected visual acuities (BCVA), manifest refractions, intraocular pressures, and perioperative complications were evaluated preoperatively and up to 24 months after the femtosecond LASER-assisted DSEK. Results: The average follow-up period was 18 months. Postoperative visual acuity had significantly improved from 1.26 (logMAR) to 0.80 (logMAR) at 3 months (p < 0.05) and this change was maintained during postoperative follow-up. All eyes underwent successful transplantation and the donor discs were well-attached. The mean endothelial cell density continued to decrease during the follow-up period. The donor-recipient stromal interface was the area where varying degree of haziness and birefringent particles were found. Conclusions: The femtosecond LASER-assisted DSEK was effective in creating an endothelial donor disc which resulted in rapid visual recovery and low surgically-induced astigmatism. However, the operation caused rapid decrease in endothelial cell density which requires continuing further consideration by the physician. J Korean Ophthalmol Soc 2011;52(6):679-689

참고문헌 (Reference)

1 서원문, "펨토초 레이져를 이용한 데스메막박리 각막내피층판 이식술의 초기 임상성적" 대한안과학회 49 (49): 40-47, 2008

2 김기언, "전층각막이식에서 봉합사 제거 후 나타나는 각막난시의 변화" 대한안과학회 44 (44): 5-288, 2003

3 이준성, "미세각막절개도를 이용한 데스메막박리 각막내피층판이식술의 국내 장기 임상 결과" 대한안과학회 51 (51): 1431-1437, 2010

4 Koenig SB, "Visual acuity, refractive error, and endothelial cell density six months after Descemet stripping and automated endothelial keratoplasty" 26 : 670-674, 2007

5 Ing JJ, "Ten year postoperative results of penetrating keratoplasty" 105 : 1855-1865, 1998

6 Eisner RA, "Technique for measuring laser in situ keratomileusis flap thickness using the IntraLase laser" 32 : 556-558, 2006

7 Ousley PJ, "Stability of vision, topography, and endothelial cell density from 1 year to 2 years after deep lamellar endothelial keratoplasty surgery" 112 : 50-57, 2005

8 Terry MA, "Replacing the endothelium without corneal surface incisions or sutures: the first United States clinical series using the deep lamellar endothelial keratoplasty procedure" 110 : 755-764, 2003

9 Sundarraj N, "Proteoglycan distribution during healing of corneal stromal wounds in chick" 67 : 433-442, 1998

10 Cheng YY, "Preliminary results of femtosecond laser assisted descemet stripping endothelial keratoplasty" 126 : 1351-1356, 2008

11 Flanagan GW, "Precision of flap measurements for laser in situ keratomileusis in 4428 eyes" 19 : 113-123, 2003

12 Ivarsen A, "Plastic particles at the LASIK interface" 111 : 18-23, 2004

13 Seitz B, "Nonmechanical posterior lamellar keratoplasty using the femtosecond laser (femtoplak) for corneal endothelial decompensation" 136 : 769-772, 2003

14 Thompson RW Jr, "Noncontact optical coherence tomography for measurement of corneal flap and residual stromal bed thickness after laser in situ keratomileusis" 19 : 507-515, 2003

15 Covert DJ, "New triple procedure Descemet’s stripping and automated endothelial keratoplasty combined with phacoemulsification and intraocular lens implantation" 114 : 1272-1277, 2007

16 Pineros O, "Long term results after penetrating keratoplasty for Fuchs’ endothelial dystrophy" 114 : 15-18, 1996

17 Fogla R, "Initial results of small incision deep lamellar endothelial keratoplasty" 141 : 346-351, 2006

18 Sonigo B, "In vivo corneal confocal microscopy comparison of intralase femtosecond laser and mechanical microkeratome for laser in situ keratomileusis" 47 : 2803-2811, 2006

19 Cheng YY, "Histologic evaluation of human posterior lamellar discs for femtosecond laser Descemet’s stripping endothelial keratoplasty" 28 : 73-79, 2009

20 Yepes N, "Five millimeter incision deep lamellar endothelial keratoplasty" 26 : 530-533, 2007

21 Durrie DS, "Femtosecond laser versus mechanical keratome flaps in wavefront-guided laser in situ keratomileusis" 31 : 120-126, 2005

22 Sarayba MA, "Femtosecond laser posterior lamellar keratoplasty" 24 : 328-333, 2005

23 Mehta JS, "Femtosecond laser creation of donor cornea buttons for Descemet stripping endothelial keratoplasty" 34 : 1970-1975, 2008

24 Cheng YY, "Femtosecond laser assisted Descemet’s stripping endothelial keratoplasty" 33 : 152-155, 2007

25 Ljubimov AV, "Extracellular matrix alterations in human corneas with bullous keratopathy" 37 : 997-1007, 1996

26 Mearza AA, "Experience and 12 month results of descemet-stripping endothelial keratoplasty (DSEK) with a small incision technique" 26 : 1292-1293, 2007

27 Price MO, "Endothelial cell loss after descemet stripping with endothelial keratoplasty influencing factors and 2 year trend" 115 : 857-865, 2008

28 Terry MA, "Endothelial cell loss after Descemet’s stripping endothelial keratoplasty in a large prospective series" 115 : 488-496, 2008

29 Cheng YY, "Efficacy and safety of femtosecond laser-assisted corneal endothelial keratoplasty" 88 : 1294-1302, 2009

30 Koenig SB, "Early results of small-incision Descemet’s stripping and automated endothelial keratoplasty" 114 : 221-226, 2007

31 Price FW Jr, "Descemet’s stripping with endothelial keratoplasty in 50 eyes" 21 : 339-345, 2005

32 Price FW Jr, "Descemet’s stripping with endothelial keratoplasty in 200 eyes" 32 : 411-418, 2006

33 Terry MA, "Deep lamellar endothelial keratoplasty visual acuity, astigmatism, and endothelial survival in a large prospective series" 112 : 1541-1548, 2005

34 Funderburgh JL, "Decorin and biglycan of normal and pathologic human corneas" 39 : 1957-1964, 1998

35 Patel SV, "Corneal endothelium and postoperative outcomes 15 years after penetrating keratoplasty" 139 : 311-319, 2005

36 Cheng YY, "Corneal endothelial viability after femtosecond laser preparation of posterior lamellar discs for Descemet stripping endothelial keratoplasty" 26 : 1118-1122, 2007

37 Espana EM, "Confocal microscopy study of donor-recipient interface after Descemet’s stripping with endothelial keratoplasty" 94 : 903-908, 2010

38 Bahar I, "Comparison of posterior lamellar keratoplasty techniques to penetrating keratoplasty" 115 : 1525-1533, 2008

39 Thomas J, "Comparison of corneal thickness measured with optical coherence tomography, ultrasonic pachymetry, and a scanning slit method" 22 : 671-678, 2006

40 Dong-Hoon Lee, "Case Report: Femtosecond Laser-Assisted Small Incision Deep Lamellar Endothelial Keratoplasty" 대한안과학회 22 (22): 43-48, 2008

41 Toti P, "CD 34 stromal expression pattern in normal and altered human corneas" 109 : 1167-1171, 2002

42 Espana EM, "CD 34 expression by cultured human keratocytes is downregulated during myofibroblast differentiation induced by TGF beta1" 45 : 2985-2991, 2004

43 Carlson EC, "Altered KSPG expression by keratocytes following corneal injury" 9 : 615-623, 2003

44 Melles GR, "A technique to excise the descemet membrane from a recipient cornea" 23 : 286-288, 2004