THE PARTIAL DESCEMET'S STRIPPING WITH TRANSPLANTATION OF DESCEMET'S TRANSPLANT UNDER ENDOTHELIAL DYSTROPHY OF CORNEA

Abstract

The DMEK technique is applied five times more rarely than DS(A)EK despite that DMEK provides higher functional result. The main causes are technical "convolution" of implementation, long period of training, accompanied by prolonged operations, higher reject control of donor's tissue, increased rate of dependency of endothelium and mismatch of transplant. Therefore, an efficient technique is needed similar to DMEK though simpler than DMEK.The purpose of study. To analyze the results of implantation of Descemet's transplant (DMET) in patients with endothelium dystrophy of cornea (Fuchs) on the basis of limited clinical observations.Material of study. In two years, DMET was implemented to 12 patients. The study included 6 patients with average age of 60±18 years (from 29 to 80 years). All female patients had primary endothelial dystrophy and one male patient had secondary endothelial dystrophy. The visual acuity prior to DMET in average made up to 0,2±0,2 (from 0,01 to 0,5). The average CTR according optical coherent eye tomography made up to 685±53 µm (from 622 to 749 µm). Results. Within available periods of observation, resorption of edema of cornea takes place in 4 patients (67%) and visual acuity increased from average 0,2±0,1 to 0,45±0,3. In various periods density of endothelium cells varied from 549 to 689 kl per mm2. The indices of optical coherent eye tomography decreased from pre-operational 685±53 µm to 553±15 µm. Conclusion. The results testify efficiency of DMET. The period of restoration of transparency of cornea can vary from 1 to 6 months. The indices of density of endothelium cells are inferior to indices after DMEK. Also, DMET is ineffective in case of secondary dystrophy and at most efficient on previously non-operated eyes.