Ординатура / Офтальмология / Английские материалы / Corneal Endothelial Transplant (DSAEK, DMEK & DLEK)_John_2010

A

Accommodation 40

AC-OCT and DSEK complications 55 AC-OCT for DSEK and DSAEK 54 Active Cltransport 15

Active Na+ transport 15 Air bubble 306 Anesthesia 173,226

Anterior chamber exploration with the Visante™ OCT 40

accommodation 40

anterior chamber measurements 40 cornea 42

crystalline lens 41

Anterior lamellar keratoplasty (ALK) 136 Anterior segment

clinical ultrasonic imaging 63 Anterior segment OCT 45 Aperture inlay 51

presbyopia correction 51 Archival system 90 Artifact removal 91

Artificial anterior chambers 124 Barron disposable ACC 127 Bausch and Lomb ACC 126 disposable ACC 127

Moria ACC 124 reusable ACC 124 types 124

Astigmatism after DLEK 181 Automated donor tissue preparation

(DSAEK) 229

B

Barrier function 14

Barron disposable ACC 127 Basal cells 76

Bowman’s layer 77

confocal microscopy appearance 76 Descemet’s membrane 78 endothelium 78

epithelium 76 stroma 77

superficial epithelial cells 77 wing cells 76

Bausch and Lomb ACC 126 Bi-fold method 292 Bioengineered cell sheet 407 Biomechanical metrics 9

implication 9 modeling 9 surgical planning 9

Biomechanics 3 intraocular pressure 7

Blood 312

anterior chamber 312 Bowman’s layer 77

C

Capsulorhexis 92 Cell preparation 408

Classification of LKP 137 age 138

depth of the recipient corneal resection 138

diameter (donor and recipient) 138 donor corneal thickness 138 general 137

location 137

number of procedures 138 stem-cell transplantation 137 substitution or addition of donor

tissue 138 surgical approach 138 type 137

use of microkeratome 138 Combined DLEK and

phacoemulsification 185 donor tissue preparation 192 phacoemulsification technique 185 recipient surgery

small incision DLEK 188 surgical procedure 185

transplantation of the donor tissue 195 Combined surgery 234

with DSAEK 234 Combining with phaco 292 Computer-aided surgery 91 Confocal microscopy 72

development 72

Congenital hereditary endothelial dystrophy (CHED) 27

Control of corneal hydration 18 Cornea 4,42

collagen structure 4 Corneal adhesive 373 Corneal anatomy 76 Corneal avascularity 18

Corneal biomechanical properties 5 in vivo measurement 6

metrics 5

new techniques 6 Corneal characteristics 80 Corneal edema 19

endothelial changes 19

epithelial edema 19 stromal edema 19

Corneal endothelial reconstruction 406 bioengineered cell sheet 407

cell preparation 408 experimental 408

gelatin carriers for HCEC sheet transplantation 415

harvest of HCEC sheets 409 HCEC sheet transplantation 409 histology 409,415 immunohistochemistry 409,413 materials 408

postoperative evaluations 410,415 preparation of gelatin hydrogel disks

408

preparation of thermoresponsive culture surfaces 408

results 410

scanning electron microscopy 413 thermoresponsive culture supports 410 viability bioassay 411

Corneal endothelium 14,16 active Cltransport 15 active Na+ transport 15 aging 24

Descemet’s membrane 26 development 24

disease 23 disease states 27

congenital hereditary endothelial dystrophy (CHED) 27

diabetes 32

endothelial dystrophies 27 Fuchs’ endothelial dystrophy 29 iridocorneal endothelial (ICE)

syndrome 28 mesenchymal dysgenesis 31 posterior polymorphous

dystrophy (PPMD) 27

toxic anterior segment syndrome (TASS) 32

electrophysiology of corneal epithelium and ion transport 15

embryology 24 endothelial barrier 17 future directions 32 health 23

morphological characteristics 24 physiology 14,16

pump and barrier function 26 pump functions 17

refractive function 14 ultrastructural characteristics 25 wound repair 24

Corneal hydration 18 control 18

Corneal hysteresis 3 Corneal innervation 18,79

Corneal metabolism and nutrition 17 Corneal physiology 14

active Cltransport 15 active Na+ transport 15

control of corneal hydration 18 corneal avascularity 18 corneal endothelium 14,16 corneal epithelium 15

corneal innervation 18

corneal metabolism and nutrition 17 corneal stroma 15

corneal thickness and hysteresis 14 electrophysiology 15

endothelial barrier 17 ion transport 15 pump functions 17 refractive function 14

Corneal slits 304 Corneal stroma 15 physiology 15

Corneal thickness and hysteresis 14 Corneal transparency 243 Crystalline lens 41

D

Deep lamellar endothelial keratoplasty (DLEK) 381

Descemet’s membrane 26,78,383 Descemet’s stripping automated endothelial keratoplasty

(DSAEK) 227, 311 postoperative complications 316

disk detachment 316 epithelial ingrowth 317 failed graft 317

graft rejection 317 infection 325 interface blood 317 macro-folds 317

recipient peripheral scraping technique 227

Descemet’s stripping with endothelial keratoplasty (DSEK) 382

Diabetes 32

Diameter (donor and recipient) 138 Digital 3D microscope system 86

archival system 90 benefits 89 computer-aided surgery 91 depth of focus 89 diagnostics 91

digital microsurgical workstation 86 display system 88

ergonomics 89 form factor 90

image acquisition 88

image enhancement tools 90 image framing 90

intelligent microscopy 90 low light levels 89 metrology 90 registration 90

working distance 90

Digital microsurgical workstation 86 Disease states 27

congenital hereditary endothelial dystrophy (CHED) 27

diabetes 32

endothelial dystrophies 27 Fuchs’ endothelial dystrophy 29 iridocorneal endothelial (ICE)

syndrome 28 mesenchymal dysgenesis 31

posterior polymorphous dystrophy (PPMD) 27

toxic anterior segment syndrome (TASS) 32

Disk detachment 316 Display system 88 Disposable ACC 127 DLEK surgery 172

indications 172 rationale 172

DLEK surgery in a large prospective study 180

astigmatism after DLEK 181 clinical results 180

donor endothelial survival after DLEK 181

large prospective study 180 visual results after DLEK 180

DLEK surgical procedure 159 donor tissue preparation 163 recipient surgery 159

transplantation of the donor tissue 165 DLEK/PLK visual recovery 363

DMEK

step-by-step surgery 400 Donor cornea 134

Donor corneal disk insertion 286 Donor corneal preparation 176,285 Donor corneal stroma 352

Donor corneal surgery 352 Donor corneal thickness 138 Donor corneal tissue 220 Donor disk 254

Donor disk adherence to recipient cornea 304

corneal slits 304 surgical technique 304

Donor disk transplantation 353

Donor endothelial survival after DLEK 181 Donor medical review 219

Donor tissue preparation 163, 192, 231, 382

DSEK procedure 231

using pre-cut tissue 177,231 without a microkeratome 178,231

Donor-recipient interface 312 fluid 312

Dropped disk 315 vitreous cavity 315

DSAEK instruments 118 DSAEK visual recovery 363

E

Early postoperative complications 396 EK techniques and manifest cylinder

outcomes 246 evolution 246

Electrophysiology 15 corneal epithelium 15 ion transport 15

Eligibility determination 219 Embryology and development 24 Endothelial barrier 17 Endothelial cell density 243

Endothelial cell harvesting technique 390 advantages 395

case example 396 complications 395 developing 390 disadvantages 395

early postoperative complications 396 histological analysis 390 instrumentation 390

late complications 396 practicing harvesting 390 TEnCell transplantation 392 viability 390

vital staining 390

Endothelial cell layer transplantation 383 endothelial cells 384

harvesting of the Descemet’s membrane 384

Endothelial changes 19 Endothelial dystrophies 27 Endothelium 78 Epithelial edema 19 Epithelial ingrowth 317 Epithelium 76 Ergonomics 89

Eye banking 219 call 219 consent 219 contact 219

donor medical review 219 eligibility determination 219 evaluation 219

physicial inspection 219

process from donor to recipient 219 recovery 219

release of tissue 219 storgae 219 transport 219

F

Failed graft 317 Femtosecond laser 294 Flipped-disk 314 Form factor 90

Fuchs’ endothelial dystrophy 29

G

Gelatin carriers 415

HCEC sheet transplantation 415 Gelatin hydrogel disks 408

Graft rejection 317

H

Harvesting technique 390 HCEC sheet transplantation 409

rabbit model 409 Histological analysis 390 Histology 409,415

Host cornea 258

Hysteresis and corneal biomechanics 8 clinical applications 8

I

ICG in DLEK 351

completion of donor corneal surgery 352

donor disk transplantation 353 ICG preparation 351

ICG staining of the donor corneal stroma 352

stromal staining 354 surgical technique 354

trypan blue staining of the donor corneal stroma in DSAEK procedure 353

Image acquisition 88

Image enhancement tools 90 Image framing 90 Immunohistochemistry 409,413 Infection 325

Instrumentation 390 Intelligent microscopy 90 Interface blood 317

Intraoperative complications 312 blood in the anterior chamber 312 disk detachment during unfolding

315

dropped disk into vitreous cavity 315 flipped-disk 314

fluid in the donor-recipient interface 312

iris prolapse 312 macro-folds 313

Iridocorneal endothelial (ICE) syndrome 28

Iris prolapse 312

J

John dexatome DSAEK spatula 108 John DSAEK 110

Descemet’s stripper 110 fixation hook 114 glider 115

inserting forceps 112 marker (8 mm/9 mm) 117 stromal scrubber 112

John PLK classification 139 optical LKP 139

John retrocorneal super micro forceps 110

John retrocorneal super micro scissors 112 John-Malbran ALK classification 138

optical LKP 138

L

Lamellar corneal dissection 49 OCT imaging 49

Lamellar keratoplasty 136

Laser scanning confocal microscope 75 Learning curve and precautions 292 LKP 139

indications 139 Low light levels 89

M

Macro-folds 313,317 Mentor system 93

dealing with complications 93 Mesenchymal dysgenesis 31 Metrology 90,93 Microkeratome 138

use of 138 Microkeratome-assisted PLK (MAPK)

369, 380 Microscopy history 72

Modified microkeratome-assisted posterior lamellar keratectomy (MMAPLK) 372

surgical technique 372 Moria ACC 124

N

New concepts in DSAEK surgery 108 John dexatome DSAEK spatula 108 John DSAEK Descemet’s stripper 110 John DSAEK fixation hook 114

John DSAEK glider 115

John DSAEK inserting forceps 112 John DSAEK marker (8 mm/9 mm)

117

John DSAEK stromal scrubber 112 John retrocorneal super micro

forceps 110

John retrocorneal super micro scissors 112

other DSAEK instruments 118 Normal cornea 3

O

Optical coherence tomography 48 accommodation 40

anterior chamber exploration 40 anterior chamber measurements 40 anterior segment 39

aperture inlay 51 cornea 42

corneal implant surgery 47 crystalline lens 41 imaging 49

lamellar corneal dissection 49 presbyopia correction 51 principles 48

refractive inlays 50 Visante™ OCT 40

P

Penetrating keratoplasty 136,368,378 Peripheral circular area of recipient corneal stroma 305

Physicial inspection 219 PKP visual recovery 362

Posterior lamellar keratoplasty 136, 369, 379

corneal adhesive 373 last advances 371

microkeratome-assisted posterior lamellar keratoplasty 369

modified microkeratome-assisted posterior lamellar keratectomy (MMAPLK) 372

modified microkeratome-assisted posterior lamellar keratoplasty surgical technique 372

scleral-pocket incision approach 370 Posterior polymorphous dystrophy

(PPMD) 27 Posterior stromal disk 385

transfer of Descemet’s membrane 385 Pre-cut corneal tissue for DSEK 333

cutting the pre-cut tissue 337 examination of the tissue 333 surgical technique 333 transplanting the tissue 338

Pump and barrier function 17, 26

R

Rabbit model 409

Real time corneal topography 93 Recipient corneal resection 138 Recipient surgery 159,173

phacoemulsification technique 185 small incision DLEK 188

Refractive function 14 Refractive inlays 50

Removal of unwanted corneal reflections and artifacts 91

Reusable ACC 124

S

Scanning electron microscopy 409,413 viability bioassay 409

Scanning-slit confocal microscope 75 Scleral-pocket incision approach 370 Single-sided scanning confocal

microscope 74

Small incision DLEK procedure 173 Spherical equivalent outcomes 247 Stem-cell transplantation 137 Stroma 77

Stromal edema 19 Stromal staining 354

Substitution or addition of donor tissue 138

Superficial epithelial cells 77 Surgical applications 91

artifact removal 91

mentor system of dealing with complications 93

metrology 93

real time corneal topography 93 removal of unwanted corneal

reflections 91

using a template for capsulorhexis 92 variable magnification within the surgical field 92

Surgical instruments for DSAEK 108 Surgical microscope 89

benefits of 3D 89 Surgical planning 9

implication 9

T

Tandem scanning confocal microscope 73 advantages 73

Tandem scanning design 74 advantages 74

prior designs 74 TEnCell transplantation 392

Thermoresponsive culture supports 409 harvest of HCEC sheets 410

Thermoresponsive culture surfaces 408 Third party preparation 332

corneal tissue for DSAEK 332 Tissue examination 333

Toxic anterior segment syndrome (TASS) 32

Transplantation of the donor tissue 165,178,195,232

Transplanting the tissue 338 Trephine diameter 254 Trypan blue 353,357

donor corneal stroma 353 DSAEK procedure 353 staining 353

U

Ultrasonic imaging and biometry of the cornea 65

Uniform Anatomical Gift Act 219

V

Viability 390

Viability bioassay 409,411 Visante™ OCT 40

Visual and refractive results 241 Visual outcomes 248

Vital staining 390

W

Wing cells 76

Wound architecture in LKP 139 Wound repair 24

Z

Z-axis scanning 73