Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Clinical Effects of Donor Cornea Variables on Outcomes After Deep Anterior Lamellar Keratoplasty: A Retrospective Research
Donör Kornea Değişkenlerinin Derin Ön Lamellar Keratoplasti Sonrası Sonuçlar Üzerine Klinik Etkileri: Retrospektif Bir Araştırma
Meltem TOKLUa, Ece TURAN VURALb, Elvin YILDIZb
aClinic of Ophthalmology, Bitlis Tatvan State Hospital, Bitlis, Türkiye
bClinic of Ophthalmology, Haydarpaşa Numune Training and Research Hospital, İstanbul, Türkiye
Turkiye Klinikleri J Ophthalmol. 2022;31(2):69-75
doi: 10.5336/ophthal.2021-85428
Article Language: EN
Full Text
ABSTRACT
 Objective: Evaluating the clinical effects of donor cornea variables on outcomes after deep anterior lamellar keratoplasty (DALK). Material and Methods: In this retrospective study, 44 eyes of 44 patients who underwent DALK using the Anwar's big bubble technique for different corneal pathologies at the ophthalmology department of Haydarpaşa Numune Training and Research Hospital were included. Preoperative and postoperative best corrected distance visual acuity (BCDVA), slit-lamp examination and complications were recorded. Postoperative refractive error, keratometry and spherical equivalent refractive error were recorded if they could be measured. Corneal wavefront aberration analysis was evaluated in 8 eyes. Donor data including age, death-to-preservation (DP) time and preservationto- surgery (PS) time were evaluated. Results: The mean patient age was 35.06±16.48 (range 15-75) years, there was a significant increase in postoperative BCDVA (range 0-1.09 logMAR) in all eyes (p<0.001). Donor age (range 18-75 years), donor endothelial cell density (range 1,739-2,456) and DP time (range 15-1,080 minutes) were not significantly associated with postoperative best corrected visual acuity, keratometric astismatism (range 0.50-9.75), refractive error (range -9.0-7.75), spherical equivalent refractive error (range -0.38-9.38) and corneal wavefront aberration analysis. PS time (range, 1-10 days) was correlated with postoperative corneal astigmatism (r=0.417; p<0.05). Donor age and postoperative spherical refractive error were statistically correlated in the negative direction (r=-0.504; p<0.05). Conclusion: PS time was correlated with keratometric astigmatism value in the positive direction, and donor age was negatively correlated with postoperative spherical refractive error. Other factors, including DP time and graft endothelial cell count were not statistically associated with postoperative outcomes.

Keywords: Corneal transplantation; eye banks
ÖZET
 Amaç: Bu çalışmanın amacı, donör kornea özelliklerinin, derin anterior lameller keratoplastinin [deep anterior lamellar keratoplasty (DALK)] sonuçlarına etkisini değerlendirmektir. Gereç ve Yöntemler: Farklı tanılarla Haydarpaşa Numune Eğitim ve Araştırma Hastanesi Göz Kliniğinde Anwar'ın büyük hava kabarcığı tekniği ile DALK yapılan 44 hastanın 44 gözü retrospektif olarak değerlendirildi. Preoperatif ve postoperatif düzeltilmiş en iyi görme keskinliği (DEİGK), postoperatif keratometri değerleri, refraksiyon kusuru, sferik eş değerleri ve karşılaşılan tüm komplikasyonlar değerlendirilerek kaydedildi. Takip edilen 8 hastanın sütür alımı sonrası korneal wavefront aberasyon analizi yapıldı. Korneası alınan donörün yaşı, korneanın endotel yoğunluğu, donörün ölümü ile korneanın alımı ve alımından naklîne kadar geçen saklama süresi çalışmamızda değerlendirmeye alındı. Bulgular: Çalışmaya alınan hastaların yaş ortalaması 35,06±16,48 (15-75) yıldı. Kırk dört gözün tümünde postoperatif DEİGK (0-1.09 logMAR) artmış izlendi. Donör yaşı (18-75 yıl), donör kornea endotel yoğunluğu (1.739-2.456), donörün ölümü ile korneanın alımı arasındaki süre (15-1.080 dk) ile postoperatif DEİGK, keratometrik astigmatizma (0,50-9,75), refraksiyon değeri (-9,0-7,75), sferik eş değer (-0,38-9,38) ve korneal wavefront aberasyon analizi ölçümleri arasında istatistiksel olarak anlamlı ilişki saptanmadı. Kornea alım-cerrahi zamanı (1-10 gün) ile postoperatif keratometrik astigmatizma ölçümleri arasında istatistiksel olarak anlamlı ilişki saptandı (r=0,417; p<0,05). Donör yaşı ile postoperatif sferik refraksiyon kusuru arasında negatif yönde istatistiksel olarak anlamlı korelasyon izlendi (r=-0,504; p<0,05). Sonuç: Donör kornea alım ve cerrahi zamanı arasındaki sürenin keratometrik astigmatizma ile pozitif yönde, donör yaşının ise postoperatif sferik refraksiyon kusuru ile negatif yönde korele olduğu saptandı. Donör kornea endotel sayısı ve ölüm ile donör kornea alım arasındaki sürenin ise postoperatif klinik sonuçlar ile istatistiksel olarak anlamlı ilişkisi gözlenmedi.

Anahtar Kelimeler: Korneal transplantasyon; göz bankası
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