Descemet stripping automated endothelial keratoplasty versus descemet membrane endothelial keratoplasty: a meta-analysis

Zhu, Leru; Zha, Yi; Cai, Jianqiu; Zhang, Yanling

doi:10.1007/s10792-017-0533-3

Cited by 38 publications

(16 citation statements)

References 39 publications

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“…When successful, DMEK surgery achieves significantly better postoperative visual acuity results than DSEAK surgery, with a higher proportion of patients achieving 20/25 vision or better. 145 Despite all these advantages, the visual results in some patients may be less than optimal even with fully functional grafts with no ocular comorbidities, suggesting that there is a ceiling on what can be achieved in some cases. 134…”

Section: Treatments For Endothelial Diseasementioning

confidence: 99%

A review of the evidence for in vivo corneal endothelial regeneration

Bogerd

Dhubhghaill

Koppen

et al. 2018

Survey of Ophthalmology

107

104

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Human corneal endothelium has long been thought to be a nonmitotic cell layer with no endogenous reparative potential. Pathologies that damage endothelial function result in corneal decompensation and, if untreated, blindness. The mainstay of treatment involves partial or complete corneal replacement, amounting to 40% of all corneal transplants performed worldwide. We summarize the case reports describing complications postoperatively in the form of (sub)total graft detachment and those resulting in postoperative bare stroma. Complications during cataract and glaucoma surgeries leading to an uncovered posterior cornea are also included. We discuss the newer treatment strategies that are alternatives for current Descemet membrane endothelial keratoplasty and Descemet stripping automated endothelial keratoplasty, including partial grafts and stripping of the diseased cell layer. In more than half of the cases reviewed, corneal transparency returned despite incomplete or no corneal endothelial cell transplantation. We question the existing paradigm concerning corneal endothelial wound healing in vivo. The data support further clinical study to determine the safety of simple descemethorexis in central endothelial pathologies, such as Fuchs endothelial corneal dystrophy, where presence of healthy peripheral cells may allow successful corneal recompensation without the need for donor cells.

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Section: Treatments For Endothelial Diseasementioning

confidence: 99%

A review of the evidence for in vivo corneal endothelial regeneration

Bogerd

Dhubhghaill

Koppen

et al. 2018

Survey of Ophthalmology

107

104

View full text Add to dashboard Cite

show abstract

“…Although Descemet's stripping automated endothelial keratoplasty (DSAEK) and Descemet membrane endothelial keratoplasties (DMEK) are now the most commonly used surgical method of endothelial keratoplasty [25][26][27], the anterior chamber injection method may be a very promising method to be clinically used. Recently, Okumura reported serial studies that con rmed injection of cultivated corneal endothelial cells supplemented with the Rock inhibitor (Y-27632) into rabbit or monkey anterior chambers could exert good therapeutic effect for corneal endothelial dysfunction [28][29][30][31].…”

Section: Discussionmentioning

confidence: 99%

Long-term observation and sequencing analysis of SKPs-derived corneal endothelial cell-like cells for treating corneal endothelial dysfunction

Shen

Sun

et al. 2020

Preprint

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Background Corneal endothelial dysfunction is a principal cause of visual deficiency. Corneal transplantation is the most effective treatment for corneal endothelial dysfunction. However, a severe shortage of available donor corneas remains a global challenge. Previously, we acquired corneal endothelial cell-like cells (CEC-like cells) derived from skin-derived precursors (SKPs). CEC-like cells exerted excellent therapeutic effect in rabbit and monkey corneal endothelial dysfunction models. Method: We prolonged the observation in the monkey experiment for 2 years. Further transcriptome sequencing was also carried out on HCEC, CEC-like cells before transplantation and after transplantation. Results We confirmed that the monkey cornea remained transparent and the CEC-like cells could adapt to the microenvironment after transplantation. The gene expression pattern of CEC-like cells was similar to HCEC and changed slightly after transplantation. Conclusions This study presented a brand-new insight into CEC-like cells and further provided a promising prospect of cell-based therapy for corneal endothelial dysfunction. The renewable cell source, novel derivation method and simple treatment strategy may be clinically applied in regenerative medicine in the future.

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“…Although Descemet's stripping automated endothelial keratoplasty (DSAEK) and Descemet membrane endothelial keratoplasties (DMEK) are now the most commonly used surgical method of endothelial keratoplasty [25][26][27], the anterior chamber injection method may be a very promising method to be clinically used. Recently, Okumura reported serial studies showing that injection of cultivated corneal endothelial cells with Rock inhibitor (Y-27632) into rabbit or monkey anterior chambers could exert good therapeutic effect for corneal endothelial dysfunction [28][29][30][31].…”

Section: Discussionmentioning

confidence: 99%

Long-term observation and sequencing analysis of SKPs-derived corneal endothelial cell-like cells for treating corneal endothelial dysfunction

Shen

Sun

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Corneal endothelial dysfunction is a principal cause of visual deficiency. Corneal transplantation is the most effective treatment for corneal endothelial dysfunction. However, a severe shortage of available donor corneas or human corneal endothelial cells (HCEC) remains a global challenge. Previously, we acquired corneal endothelial cell-like cells (CEC-like cells) derived from human skin-derived precursors (SKPs). CEC-like cells were injected into rabbit and monkey corneal endothelial dysfunction models and exerted excellent therapeutic effect. Method We prolonged the clinical observation in the monkey experiment for 2 years. PCR and DNA sequencing were carried out to confirm the existence of CEC-like cells. Histological examinations were carried out to show the corneal morphology. Further transcriptome sequencing was also carried out on HCEC, CEC-like cells before transplantation and after transplantation. Results The monkeys cornea remained transparent and normal thickness. The total endothelial cell density decreased gradually, but tended to be stable and remained in a normal range during 2-year observation. The CEC-like cells persist during observation and could adapt to the microenvironment after transplantation. The gene expression pattern of CEC-like cells was similar to HCEC and changed slightly after transplantation. Conclusions CEC-like cells could adapt to the microenvironment and had a good therapeutic effect after being transplanted into the monkey endothelial dysfunction model during long-term observation. This study provided a promising prospect of cell-based therapy for corneal endothelial dysfunction and may be clinically applied in regenerative medicine in the future.

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Descemet stripping automated endothelial keratoplasty versus descemet membrane endothelial keratoplasty: a meta-analysis

Abstract: Our meta-analysis suggests that DMEK provided better visual outcomes with similar safety when compared to DSAEK. Given the limited sample size, further investigations are needed to validate these findings.

Cited by 38 publications

References 39 publications

A review of the evidence for in vivo corneal endothelial regeneration

A review of the evidence for in vivo corneal endothelial regeneration

Long-term observation and sequencing analysis of SKPs-derived corneal endothelial cell-like cells for treating corneal endothelial dysfunction

Long-term observation and sequencing analysis of SKPs-derived corneal endothelial cell-like cells for treating corneal endothelial dysfunction

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