与浅前房相关的大泡性角膜病变：角膜内皮失代偿的解剖学风险表型
Bullous keratopathy associated with a shallow anterior chamber: An anatomical risk phenotype for corneal endothelial decompensation.
摘要(中文译文)
旨在描述与浅前房（AC）相关的大疱性角膜病变（BK）的特征，并探讨即使在没有急性原发性闭角（APAC）或氩激光虹膜切开术（ALI）的情况下，浅前房本身是否可能与角膜内皮失代偿相关。这项多中心回顾性观察研究纳入了2015年至2025年间因内皮功能障碍接受后弹力层内皮角膜移植术（DMEK）且随访≥12个月的96只眼。主要比较分析比较了Fuchs内皮性角膜营养不良（FECD）眼与伴有浅前房的内皮功能障碍眼。浅前房表型组包括有APAC或ALI明确病史的眼（PACD/ALI）以及无上述任一情况明确病史的眼（浅前房）。比较了各组间的前房深度（ACD）、眼轴长度、角膜厚度、内皮参数及术后结局。浅前房表型组白内障术前ACD显著浅于FECD组（1.93 ± 0.40 mm vs. 2.28 ± 0.27 mm，P < 0.001），且这一相对差异在白内障手术后持续存在。在浅前房表型组内，10只眼被归类为浅前房，且无APAC或ALI的明确病史。DMEK术后5年移植物存活率超过90%，且在浅前房表型组与FECD组之间、以及PACD/ALI与浅前房亚组之间均无显著差异。即使没有APAC或ALI，浅前房也可能与角膜内皮失代偿相关。通过适当的围手术期管理，DMEK在这些眼中可提供良好的长期结局。
Abstract
To characterize bullous keratopathy (BK) associated with a shallow anterior chamber (AC) and to examine whether a shallow AC itself may be associated with corneal endothelial decompensation, even in the absence of acute primary angle closure (APAC) or argon laser iridotomy (ALI). This multicenter retrospective observational study included 96 eyes that underwent Descemet membrane endothelial keratoplasty (DMEK) for endothelial dysfunction between 2015 and 2025 with ≥12 months of follow-up. The primary comparative analyses compared eyes with Fuchs endothelial corneal dystrophy (FECD) and eyes with endothelial dysfunction associated with a shallow AC. The shallow anterior chamber phenotype group comprised eyes with a documented history of APAC or ALI (PACD/ALI) and those without a documented history of either condition (shallow-AC). Anterior chamber depth (ACD), axial length, corneal thickness, endothelial parameters, and postoperative outcomes were compared between groups. Pre-cataract ACD was significantly shallower in the shallow anterior chamber phenotype group than in the FECD group (1.93 ± 0.40 mm vs. 2.28 ± 0.27 mm, P < 0.001), and this relative difference persisted after cataract surgery. Within the shallow anterior chamber phenotype group, 10 eyes were classified as shallow-AC and had no documented history of APAC or ALI. Five-year graft survival after DMEK exceeded 90% and did not differ significantly between the shallow anterior chamber phenotype and FECD groups, nor between PACD/ALI and shallow-AC subgroups. A shallow anterior chamber may be associated with corneal endothelial decompensation, even in the absence of APAC or ALI. With appropriate perioperative management, DMEK may provide favorable long-term outcomes in these eyes.
如何引用
AMA
Masato Takeda, Yuki Mizuki, Ami Igarashi, Toshiki Shimizu, Naoki Okumura, Nobuhisa Mizuki, et al. Bullous keratopathy associated with a shallow anterior chamber: An anatomical risk phenotype for corneal endothelial decompensation.. PloS one. 2026; doi:10.1371/journal.pone.0353272.
APA
Masato Takeda, Yuki Mizuki, Ami Igarashi, Toshiki Shimizu, Naoki Okumura, Nobuhisa Mizuki, et al (2026). Bullous keratopathy associated with a shallow anterior chamber: An anatomical risk phenotype for corneal endothelial decompensation.. PloS one. https://doi.org/10.1371/journal.pone.0353272
GB/T 7714
Masato Takeda, Yuki Mizuki, Ami Igarashi, Toshiki Shimizu, Naoki Okumura, Nobuhisa Mizuki, et al. Bullous keratopathy associated with a shallow anterior chamber: An anatomical risk phenotype for corneal endothelial decompensation.[J]. PloS one, 2026 doi:10.1371/journal.pone.0353272.
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