NEW METHOD OF GRAFT FORMATION FOR POSTERIOR AUTOMATED LAMELLAR KERATOPLASTY IN THE TREATMENT OF PATIENTS WITH EPITHELIAL AND ENDOTHELIAL CORNEAL DYSTROPHY

Purpose of the study was to conduct a comparative analysis of the results of the posterior automated lamellar keratoplasty (PALK), performed using different types of microkeratomes in patients with epithelial and endothelial corneal dystrophy (EECD).The study included 56 patients (56 eyes) with EECD, who underwent PALK in Ufa Eye Research Institute between 2011 and2016. The main group consisted of 29 patients (29 eyes) who underwent PALK using a graft made of PocketMaker microkeratome (DioptexGmbh, Austria). The control group consisted of 27 patients (27 eyes), in which the stage of graft dissection was performed using a Moria microkeratome (France) according to the standard procedure.An increase in the corrected visual acuity was achieved up to 0.8 in the main group compared to the control 0.6 (p <0.01) 12 months after PALK. The decrease in endothelial cell density (ECD) was 34% (1963 ± 354 cells / mm2) in the main group and 40% (1789 ± 172 cells / mm2, p <0.01) in the control group compared to baseline values (2976 ± 240 cells / mm2).A comparative analysis showed the advantages of using grafts made of the PocketMaker microkeratome compared to Moria during PALK, confirmed by morphological and functional results. Transplantability in 12 months was 89,7% in the main group and 81,5% in the control group.

эпителиально-эндотелиальная дистрофия роговицы, буллезная кератопатия, задняя автоматизиро- ванная послойная кератопластика, Descemet-stripping automated endothelial keratoplasty (DSAEK), плотность эндотелиальных клеток, Epithelial and endothelial corneal dystrophy, bullous keratopathy, posterior automated lamellar keratoplasty, descemet-stripping automated endothelial keratoplasty, endothelial cells density

1. Бикбов, М.М. Способ одномоментного приготовления роговичных трансплантатов для ламеллярной и эндотелиальной кератопластики / М.М. Бикбов, Г.М. Бикбова // Патент на изобретение РФ № 2456969 от 27.07.2012

2. Бикбов, М.М. Эктазии роговицы / М.М. Бикбов, Г.М. Бикбова. - М.: Апрель, 2011. - 162 с

3. Малюгин, Б.Э. Первый опыт и клинические результаты задней автоматизированной послойной кератопластики (ЗАПК) с использованием предварительно выкроенных консервированных ультратонких роговичных трансплантатов / Б.Э. Малюгин, З. Мороз, С. Борзенок // Офтальмохирургия. - 2013. - № 3. - С.12-16

4. Оганесян, О.Г. Эндокератопластика как альтернатива сквозной кератопластике / О.Г. Оганесян // Офтальмология. - 2009. - № 2. - С.15-21

5. Труфанов, С.В. Современные возможности функциональной реабилитации больных с буллезной кератопатией и сопутствую- щей глаукомой на основе эндотелиальной кератопластики / С.В. Труфанов, С.А. Маложен // Вестник офтальмологии. - 2014. - № 2. - С. 27-31

6. Acar, B. Comparison of Sulfur Hexafluoride and Air for Donor Attachment in Descemet Stripping Endothelial Keratoplasty in Patients With Pseudophakic Bullous Keratopathy / B. Acar, O. Muftuoglu, S. Acar // Cornea. - 2014. - Vol. 33, № 3. - P. 219-222

7. Aldave, A. Outcomes After DSEK in 101 Eyes With Previous Trabeculectomy and Tube Shunt Implantation / A. Aldave, J. Chen, A. Zaman [et al.] // Cornea. - 2014. - Vol.33, № 3. - P. 320-324

8. Bikbov, M. Outcomes of Descemet stripping pocketmaker endothelial keratoplasty in the pseudophakic bulllosus keratopathy treatment / M. Bikbov, G. Bikbova L. Marvanova. - Milan - 3rd Eurocornea congress. - 2012

9. Duman, F. Indications and outcomes of corneal transplantation in geriatric patients / F. Duman, M. Kosker, K. Suri // Am J Ophthalmol. - 2013. - Vol.156. - P.600-607.e2 doi: 10.1016/j.ajo.2013.04.034

10. De Sanctis, U. Wave-Like Opacities at the Interface After Descemet Stripping Automated Endothelial Keratoplasty / U. De Sanctis, L. Brusasco, F. Grignolo // Cornea. - 2012. - Vol.31, №11. - P.1335-1338

11. Ferrendelli, J. Endothelial Keratoplasty [Электронный ресурс] / J. Ferrendelli // Kaneka Corp, Settsu Osaka Japan, 2012. - Режим доступа: http://www.fepblue.org/downloads/9_03_22_Endothelial_Keratoplasty.pdf

12. Gorovoy M.S. Descemet-strippiing automated endothelial keratoplasty / M.S. Gorovoy // Cornea. - 2006. - 26. - P.886-889

13. Iwama, Y. Factor limiting the visual outcome after Descemet stripping automated endothelial keratipolasty: comprehensive analysis including the graft position and irregularity / Y. Iwama, T. Soma, N. Maeda // Cornea. - 2018. - Vol. 37. - №1. - P. 20-27

14. Hood C., Soong H. Prone Positioning to Facilitate Graft Adherence in the Late Postoperative Period After Descemet Stripping Automated Endothelial Keratoplasty / C. Hood, H. Soong // Cornea. - 2014. - Vol. 33, № 6. - P. 628-629

15. Nakagawa, H. Clinical outcomes in descemet stripping automated endothelial keratoplasty with internationally shipped precut donor corneas / H. Nakagawa, T. Inatomi, O. Hieda // Am J Ophthalmol. - 2014. - Vol.157. - P. 50-5.e1

16. Nakatani, S. Descemet stripping automated endothelial keratoplasty using corneas from elderly donors / S. Nakatani, А. Murakami // Graefe's Archive for Clinical and Experimental Ophthalmology. - 2016. - Vol. 254. - № 6. - Р.1135-1140

17. Melles, G. A surgical technique for posterior lamellar keratoplasty / G. Melles, F. Eggjnk, F. Lander // Cornea. - 1998. - Vol. 17. - P. 618-626

18. Nuijts, R. Exciting times for corneal surgeons // EUROTIMES. - 2009. - Vol. 14, № 4. - P. 1

19. Pedersen, I.B. Graft rejection and failure following endothelial keratoplasty (DSAEK) and penetrating keratoplasty for secondary endothelial failure / I.B.Pedersen, A. Ivarsen, J. Hjortdal // Acta Ophthalmol. - 2015. - Vol. 93. - P.172-177

20. Sharma, N. Descemet stripping automated endothelial keratoplasty / N. Sharma P.K. Maharana, S. Singhi // Indian J Ophthalmol. - 2017. - Vol. 65, №3. - Р.198-209

21. Tan, JC. Evolving indications for and trends in keratoplasty in British Columbia, Canada, from 2002 to 2011: A 10 year review / J.C. Tan, S.P. Holland, P.J. Dubord // Cornea. - 2014. - Vol.33. - P.252 256

22. Terry, M.A. Endothelial keratoplasty: Prospective, randomized, masked clinical trial comparing an injector with forceps for tissue insertion / M.A.Terry, M.D.Straiko, J.M.Goshe // Am J Ophthalmol. - 2013. - Vol.156, №1. - P. 61-68.e3

23. Terry, M. Endothelial Keratoplasty: Why Aren't We All Doing Descemet Membrane Endothelial Keratoplasty? // Cornea. - 2012. - Vol. 31, № 5. - P. 469-471

24. Titiyal, JS. Sutureless clear corneal DSAEK with a modified approach for preventing pupillary block and graft dislocation: Case series with retrospective comparative analysis / J.S. Titiyal, S.I. Tinwala, H Shekhar // Int Ophthalmol. - 2015. - Vol.35. - P. 233-240

25. Toyama, T. New Graft Inserter for Descemet Stripping Automated Endothelial Keratoplasty / T. Toyama, T. Honda, N. Usui // Cornea. - 2014. - Vol. 33. - P. 423-435

26. Woodward, M. Effect of Microkeratome Pass on Tissue Processing for Descemet Stripping Automated Endothelial Keratoplasty / M. Woodward, M. Titus R. Shtein // Cornea. - 2014. - Vol. 33. - № 5. - P. 507-509