海外ドナープレカット角膜および国内ドナー角膜を用いた角膜内皮移植術の術後短期成績

Short-term outcome of Descemet's stripping automated endothelial keratoplasty（DSAEK）using domestic or imported precut donor cornea

要約　目的：角膜内皮移植術の術後短期成績を海外プレカット角膜と国内術直前カット角膜で比較した。

方法：水疱性角膜症に対して角膜内皮移植単独手術を施行された症例から機能的濾過胞眼，眼内炎後を除外した65例76眼で，視力，角膜内皮細胞密度，術後合併症を後ろ向きに検討した。

結果：術後1か月の視力は海外群が有意に高かったが，3か月，6か月の視力と術前後の角膜内皮細胞密度，合併症発生率には有意差はなかった。

結論：海外プレカット角膜を使用した角膜内皮移植は国内術直前カット角膜を使用した群に比べて術後早期の視力回復が早かった。

Abstract　Purpose: To report short-term outcome of Descemet's stripping automated endothelial keratoplasty（DSAEK）using domestic or imported precut donor cornea.

Cases and Method: This retrospective study was made on 76 eyes that received DSAEK for bullous keratopathy in the past 55 months. These 76 eyes were enrolled from a series of 150 eyes after exclusion of eyes with filtering bleb, endophthalmitis, and history of keratoplasty among others. The donor cornea had been dissected with a microkeratome by domestic surgeons or overseas eye bank technicians. The outcome was evaluated 3 months after surgery regarding endothelial cell density, best-corrected visual acuity（BCVA）, complications including primary graft failure, and rejection rates.

Results: Median value of BCVA at one month after surgery was better in eyes that received imported than domestic donor cornea（p＝0.01）. There were no significant differences between domestic and imported donor cornea regarding endothelial corneal density, postoperative complications, or BCVA 3 to 6 months after surgery.

Conclusion: There was no difference between domestic and imported cornea regarding endothelial corneal density or postoperative complications. Use of imported cornea resulted in more rapid recovery of vision after DSAEK.