Biography
Biography: Jing Hong
Abstract
Nowadays, Endothelial Keratoplasty (EK) has become the mainstay of treatment for corneal endothelium disorders. Smaller incision, thinner graft and faster vision recovery are the trends for EK. DMEK, more consistency with corneal anatomy is preferred by more doctors worldwide. However, corneal endothelium dysfunction in China has its own unique features. We overviewed our DMEK patients from 2007-2016 with total number 1142. Most of them are combined surgeries. There are 4 features which are as follow: First feature: Shallow anterior chamber (AC), peripheral iris bulge and narrow angle, thick lens. Second feature: Severe corneal edema with opacity. Causes for this bad situation are delay of seeking treatment, lack of donor cornea, mean waiting time for donor cornea is 6 months. One of the characteristic in China is, almost every case is the end stage when patient agree to do the operation. Most of their vision acuity is figure counting, which makes the surgery more challenging because the cornea is too swollen to see the cataract clearly. Third feature: More complicated combined surgery, simple EK 35.71%, combined surgery 64.29%. Fourth feature: Disorganized ocular structure for those seriously trauma, sometimes, PKP is performed combined with silicone oil tamponade to ensure the retina reattached well, however it may result in endothelium dysfunction. Peripheral anterior synechiae (PAS) easily occurs with thick corneal endothelium graft in Asian eye. So it can be concluded that DMEK is not suitable for majority complicated cases in China, since the cases are very complicated. Most cases are complicated with shallow AC, severe corneal opacity and difficult intraocular status. So combined surgeries are required. Ultra-DSEK is currently adapted to our need in Chinese patients with the features mentioned above. Ultra-DSEK is the most suitable EK procedure in China.