臨床眼科67巻13号

2013年12月発行

特集 新しい角膜パーツ移植

角膜内皮移植

著者： 小林顕¹

所属機関： ¹金沢大学附属病院眼科

ページ範囲：P.1944 - P.1950

はじめに

　ここ10年で，角膜内皮障害（水疱性角膜症）に対する外科的治療の中心は全層角膜移植から角膜内皮パーツ移植（以下，内皮移植）へと大きく変化した。アメリカアイバンク協会（Eye Bank Association of America）の発表によると，2005年には角膜移植全体に占める内皮移植の割合はわずか4.5％だったのに対して，2012年には，40％以上が内皮移植となっている^1）。本稿では，現在世界的に行われている内皮移植であるDSAEK（Descemet's stripping automated endothelial keratoplasty）とDMEK（Descemet's membrane endothelial keratoplasty）の話題を中心として解説する。

参考文献

1）Eye Bank Association of America：2012 Eye Banking Statistical Report. Available at　http://www.restoresight.org.

2）Price FW Jr, Price MO：Descemet's stripping with endothelial keratoplasty in 200 eyes：early challenges and techniques to enhance donor adherence. J Cataract Refract Surg　32：411-418, 2006

3）Terry MA, Hoar KL, Wall J et al：Histology of dislocations in endothelial keratoplasty（DSEK and DLEK）：a laboratory-based, surgical solution to dislocation in 100 consecutive DSEK cases. Cornea　25：926-932, 2006

4）Gorovoy MS：Descemet-stripping automated endothelial keratoplasty. Cornea　25：886-889, 2006

5）Price MO, Jordan CS, Moore G et al：Graft rejection episodes after Descemet stripping with endothelial keratoplasty：part two：the statistical analysis of probability and risk factors. Br J Ophthalmol　93：391-395, 2009

6）Price MO, Fairchild KM, Price DA et al：Descemet's stripping endothelial keratoplasty five-year graft survival and endothelial cell loss. Ophthalmology　118：725-729, 2011

7）Yokogawa H, Kobayashi A, Sugiyama K：Clinical evaluation of a new donor graft inserter for Descemet's stripping automated endothelial keratoplasty. Ophthalmic Surg Lasers Imaging　43：50-56, 2012

8）Kobayashi A, Yokogawa H, Sugiyama K：Clinical results of the Neusidl Corneal Inserter, a new donor inserter for Descemet's stripping automated endothelial keratoplasty, for small Asian eyes. Ophthalmic Surg Lasers Imaging　43：311-318, 2011

9）Ham L, Dapena I, van Luijk C et al：Descemet membrane endothelial keratoplasty（DMEK）for Fuchs endothelial dystrophy：review of the first 50 consecutive cases. Eye　23：1990-1998, 2009

laser confocal microscopy after Descemet's membrane endothelial keratoplasty. Ophthalmology　120：923-930, 2013

11）Anshu A, Price MO, Price FW Jr et al：Risk of corneal transplant rejection significantly reduced with Descemet's membrane endothelial keratoplasty. Ophthalmology　119：536-540, 2012

12）Kobayashi A, Yokogawa H, Sugiyama K：Descemet stripping with automated endothelial keratoplasty for bullous keratopathies secondary to argon laser iridotomy―preliminary results and usefulness of double-glide donor insertion technique. Cornea　27（Suppl 1）：S62-69, 2008

13）Yokogawa H, Kobayashi A, Saito Y et al：Rationale for performing penetrating keratoplasty rather than DSAEK in patients with bullous keratopathy in Japan. Ophthalmic Surg Lasers Imaging　43：446-451, 2012

14）Kobayashi A, Yokogawa H, Sugiyama K：Non-Descemet stripping automated endothelial keratoplasty for endothelial dysfunction secondary to argon laser iridotomy. Am J Ophthalmol　146：543-549, 2008

15）Chaurasia S, Ramappa M, Sangwan VS：Clinical outcomes of non-Descemet stripping automated endothelial keratoplasty. Int Ophthalmol　32：571-575, 2012

16）Masaki T, Kobayashi A, Yokogawa H et al：Clinical evaluation of non-Descemet stripping automated endothelial keratoplasty（nDSAEK）. Jpn J Ophthalmol　56：203-207, 2012

17）Busin M, Madi S, Santorum P et al：Ultrathin Descemet's stripping automated endothelial keratoplasty with the microkeratome double-pass technique：two-year outcomes. Ophthalmology　120：1186-1194, 2013

18）Da Reitz Pereira C, Guerra FP, Price FW Jr et al：Descemet's membrane automated endothelial keratoplasty（DMAEK）：visual outcomes and visual quality. Br J Ophthalmol　95：951-954, 2011