[Clinical and functional results of one-step phaco surgery and central descemetorhexis for cataract and Fuchs primary endothelial corneal dystrophy].

Autor:	Malyugin BE; S. Fyodorov Eye Microsurgery Federal State Institution, 59a Beskudnikovskiy blvd, Moscow, Russian Federation, 127486., Izmaylova SB; S. Fyodorov Eye Microsurgery Federal State Institution, 59a Beskudnikovskiy blvd, Moscow, Russian Federation, 127486., Malyutina EA; S. Fyodorov Eye Microsurgery Federal State Institution, 59a Beskudnikovskiy blvd, Moscow, Russian Federation, 127486., Antonova OP; S. Fyodorov Eye Microsurgery Federal State Institution, 59a Beskudnikovskiy blvd, Moscow, Russian Federation, 127486., Gelyastanov AM; S. Fyodorov Eye Microsurgery Federal State Institution, 59a Beskudnikovskiy blvd, Moscow, Russian Federation, 127486.
Jazyk:	ruština
Zdroj:	Vestnik oftalmologii [Vestn Oftalmol] 2017; Vol. 133 (6), pp. 16-22.
DOI:	10.17116/oftalma2017133616-22
Abstrakt:	Poor visual function associated with Fuchs endothelial corneal dystrophy (FECD) is one of the main indications for keratoplasty. Reports of successful visual rehabilitation of patients with spontaneous or scheduled removal of the Descemet's membrane and the endothelium or donor material adhesion failure, suggest this research direction perspective. Aim: to evaluate the potential as well as clinical and functional outcomes of phacoemulsification with central circular descemetorhexis in patients with Fuchs endothelial corneal dystrophy. Material and Methods: A total of 19 patients aged 51-84 years were included. The preoperative best corrected visual acuity averaged 0.32±0.19, endothelial cells density - 629.6±336.9 cells/mm 2 , and central corneal pachymetry - 587.8±44.8 µm. After phacoemulsification with IOL implantation, a 4 mm tap was created from the epithelial side of the cornea. Central circular descemetorhexis was done using a microhook. The membrane was removed with microforceps. Results: On day 1, there was central corneal edema matching the circular defect in the Descemet's membrane. As many as 26.3% of patients demonstrated rapid responses to the treatment, which implies that corneal transparency and visual improvement were achieved by the end of the first month after surgery. In other 26.3% of patients, full corneal transparency was not achieved and, therefore, endothelium transplantation had to be performed. The main group included 12 patients. At 12 months, the best corrected visual acuity was 0.66±0.29, central pachymetry - 569.27±63.74 µm, endothelial cells density - 634.00±170.41 cells/mm 2 . Conclusion: In 63.8% of patients, visual rehabilitation was achieved without endothelial transplantation, which provides new prospects for tissue-saving technologies in patients with endothelial corneal dystrophy.
Databáze:	MEDLINE
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