Intracellular dark endothelial spots detected using specular microscopy are associated with graft failure after Descemet's membrane endothelial keratoplasty.

IF 2.4 3区医学 Q2 OPHTHALMOLOGY Graefe’s Archive for Clinical and Experimental Ophthalmology Pub Date : 2025-05-01 Epub Date: 2025-01-25 DOI:10.1007/s00417-025-06745-5

Ami Igarashi, Masato Takeda, Naoko Mashiko, Toshiki Shimizu, Kentaro Yuda, Yoshinori Oie, Naoki Okumura, Takefumi Yamaguchi, Satoru Yamagami, Takahiko Hayashi

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Abstract

Purpose: To investigate the correlation between intracellular dark endothelial spots (IDESs) detected by specular microscopy and the incidence of graft failure after Descemet's membrane endothelial keratoplasty (DMEK).

Methods: We reviewed 100 consecutive DMEK patients performed by a single surgeon at two centres between January 2015 and July 2022. Central corneal thickness was evaluated using anterior segment optical coherence tomography (SS-1000; Tomey, Aichi, Japan), and endothelial cell density was measured using specular microscopy. Kaplan-Meier estimates and Cox regression models were used to evaluate graft failure and associated risk factors.

Results: Of the 97 eyes included, 9 experienced graft failure within the follow-up period (52.9 ± 23.9 months). IDES presence significantly correlated with decreased endothelial cell density and higher graft failure rates (hazard ratio = 4.68, 95% confidence interval = [0.96, 22.7], P = 0.034).

Conclusion: IDESs represent a significant risk factor for graft failure post-DMEK. Careful postoperative management is imperative to minimise this risk.

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利用镜面显微镜检测到的细胞内暗内皮斑点与Descemet膜内皮角膜移植术后移植失败有关。

目的：探讨Descemet膜内皮角膜移植术（DMEK）后细胞内暗内皮斑点（IDESs）与移植失败发生率的关系。方法：我们回顾了2015年1月至2022年7月期间由一名外科医生在两个中心连续手术的100例DMEK患者。采用前段光学相干断层扫描(SS-1000；Tomey，爱知，日本)，内皮细胞密度用镜面显微镜测量。Kaplan-Meier估计和Cox回归模型用于评估移植物衰竭和相关危险因素。结果：97只眼中，9只眼在随访期间（52.9±23.9个月）出现移植失败。IDES的存在与内皮细胞密度降低和移植失败率升高显著相关（风险比= 4.68,95%可信区间= [0.96,22.7],P = 0.034）。结论：IDESs是dmek后移植物衰竭的重要危险因素。仔细的术后管理是减少这种风险的必要条件。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Graefe’s Archive for Clinical and Experimental Ophthalmology 医学-眼科学

CiteScore

5.40

自引率

7.40%

发文量

398

审稿时长

3 months

期刊介绍： Graefe''s Archive for Clinical and Experimental Ophthalmology is a distinguished international journal that presents original clinical reports and clini-cally relevant experimental studies. Founded in 1854 by Albrecht von Graefe to serve as a source of useful clinical information and a stimulus for discussion, the journal has published articles by leading ophthalmologists and vision research scientists for more than a century. With peer review by an international Editorial Board and prompt English-language publication, Graefe''s Archive provides rapid dissemination of clinical and clinically related experimental information.