수포각막병증환자에서 심층각막내피이식의 치료성적

Results of Deep Lamellar Endothelial Keratoplasty (DLEK)

Purpose: To evaluate the clinical results of deep lamellar endothelial keratoplasty (DLEK) surgery in patients with bullous keratopathy. Methods: Seven eyes of 7 patients diagnosed with bullous keratopathy were evaluated for pre- and postoperative visual acuity, refractive error, astigmatism, and corneal topographic results. Specular microscopy and corneal pachymetry was performed in order to evaluate the corneal endothelial cell status. Postoperative complications such as graft rejection, infection, glaucoma, and graft dislocation were also evaluated. Results: Preoperative visual acuity improved from 0.006 (CF ~ 0.02) to 0.4 (0.1 ~ 0.5) at an average of 1.2±0.18 years of follow-up. Manifest refraction, topographic astigmatism, corneal endothelial cell density, and central corneal thickness at the final visit were 1.21±0.73D, 2.1±0.70D, 1304±682 cells/mm2, and 504±128 ?m respectively. Two eyes (28.6%) developed graft rejection, one of which recovered after intensive steroid treatment. However, one patient (14.3%) underwent penetrating keratoplasty due to graft failure at 6 months postoperatively. Seven of 7 eyes were noted to have graft dislocation, all of which were repositioned and attached after air injection or suture. Conclusions: DLEK surgery is an effective alternative to conventional penetrating keratoplasty for bullous keratopathy patients because of fast visual recovery and low incidence of postoperative astigmatism.