Development of new keratoplasty technique-DMEK/DMAEK/PDEK-

• Project/Area Number: 16K11261
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Ophthalmology
• Research Institution: Kanazawa University
• Principal Investigator: KOBAYASHI AKIRA 金沢大学, 医学系, 講師 (20303274)
• Project Period (FY): 2016-04-01 – 2019-03-31
• Project Status: Completed (Fiscal Year 2018)
• Budget Amount: ¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000); Fiscal Year 2018: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000); Fiscal Year 2017: ¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000); Fiscal Year 2016: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000)
• Keywords: 角膜移植 / DSAEK / DMEK / confocal microscopy / 光干渉断層計 / Endothelial keratoplasty / DMAEK / PDEK

Outline of Final Research Achievements

We established novel surgical device and technqiues concerning DSAEK and DMEK. The device has become avilable from ASICO company. By using this device, the surgical time shortened with less endothelial cell damages. We further study the importance of corneal epithelial cells during DMEK surgery using OCT and confocal microscopy.

Academic Significance and Societal Importance of the Research Achievements

これらの結果から考えられる意義は以下の通りである。(1)DMEK/DMAEK/PDEKにおいては、DSAEKに比較して良好な視力が得られるが、それらは、上皮下混濁、層間混濁、層間沈着物などが少ないことが関与している可能性が推測された。また、術後視機能と層間混濁の関連性が明らかになった。これらの結果は、どの角膜内皮移植が最適な術式であるかを決める参考となる。(2)DMEK/DMAEK/PDEK専用器具が開発されたことにより、より安全な術式となり、日本国内のみならず、アジアを含めた世界的に普及が期待される。

Research Products

• [Journal Article] Risk factors for Cystoid Macular Edema After Descemet Membrane Endothelial Keratoplasty (2019)
  • Author(s): Inoda Satoru、Hayashi Takahiko、Takahashi Hidenori、Oyakawa Itaru、Yokogawa Hideaki、Kobayashi Akira、Kato Naoko、Kawashima Hidetoshi
  • Journal Title: Cornea Volume: in press Issue: 7 Pages: 820-824
  • DOI: 10.1097/ico.0000000000001950
  • Peer Reviewed
• [Journal Article] In vivo histology and p.L132V mutation in KRT12 gene in Japanese patients with Meesmann corneal dystrophy (2018)
  • Author(s): Nishino Tsubasa、Kobayashi Akira、Mori Natsuko、Masaki Toshinori、Yokogawa Hideaki、Fujiki Keiko、Yanagawa Ai、Murakami Akira、Sugiyama Kazuhisa
  • Journal Title: Japanese Journal of Ophthalmology Volume: 63 Issue: 1 Pages: 46-55
  • DOI: 10.1007/s10384-018-00643-6
  • NAID: 210000188449
  • Peer Reviewed
• [Journal Article] Development of a Donor Tissue Holding Technique for Descemet’s Membrane Endothelial Keratoplasty Using a 25-Gauge Graft Manipulator (2018)
  • Author(s): Kobayashi Akira、Yokogawa Hideaki、Mori Natsuko、Masaki Toshinori、Sugiyama Kazuhisa
  • Journal Title: Case Reports in Ophthalmology Volume: 9 Issue: 3 Pages: 431-438
  • DOI: 10.1159/000493571
  • Peer Reviewed
• [Journal Article] Combined Keratoplasty, Pars Plana Vitrectomy, and Flanged Intrascleral Intraocular Lens Fixation to Restore Vision in Complex Eyes With Coexisting Anterior and Posterior Segment Problems (2018)
  • Author(s): Yokogawa Hideaki、Kobayashi Akira、Okuda Tetsuhiko、Mori Natsuko、Masaki Toshinori、Sugiyama Kazuhisa
  • Journal Title: Cornea Volume: 37 Issue: 1 Pages: S78-S85
  • DOI: 10.1097/ico.0000000000001716
  • Peer Reviewed
• [Journal Article] A 10-year review of underlying diseases for endothelial keratoplasty (DSAEK/DMEK) in a tertiary referral hospital in Japan (2018)
  • Author(s): Nishino Tsubasa、Kobayashi Akira、Yokogawa Hideaki、Mori Natsuko、Masaki Toshinori、Sugiyama Kazuhisa
  • Journal Title: Clinical Ophthalmology Volume: Volume 12 Pages: 1359-1365
  • DOI: 10.2147/opth.s170263
  • Peer Reviewed
• [Journal Article] Double-Bubble Technique in Descemet Membrane Endothelial Keratoplasty for Vitrectomized Eyes (2018)
  • Author(s): Hayashi Takahiko、Kobayashi Akira
  • Journal Title: Cornea Volume: 37 Issue: 9 Pages: 1185-1188
  • DOI: 10.1097/ico.0000000000001606
  • Peer Reviewed
• [Journal Article] Clinical evaluation of a novel surgical technique (large cross incision) for conjunctival cysts. (2018)
  • Author(s): Nishino T, Kobayashi A, Mori N, Masaki T, Yokogawa H, Sugiyama K.
  • Journal Title: Can J Ophthalmol Volume: 53(1) Issue: 1 Pages: e36-e39
  • DOI: 10.1016/j.jcjo.2017.06.013
  • Peer Reviewed
• [Journal Article] Spontaneous reattachment of dislocated endothelial graft after non-Descemet stripping automated endothelial keratoplasty: a case report (2018)
  • Author(s): Kodama-Takahashi Aya、Fukuda Masahiko、Sugioka Koji、Kobayashi Akira、Shimomura Yoshikazu
  • Journal Title: BMC Ophthalmology Volume: 18 Issue: 1 Pages: 14-14
  • DOI: 10.1186/s12886-018-0684-7
  • Peer Reviewed
• [Journal Article] Association of fluorescein anterior corneal mosaic and corneal K-structures by in vivo laser confocal microscopy in patients with keratoconus. (2017)
  • Author(s): Kobayashi A, Yokogawa H, Mori N, Masaki T, Sugiyama K.
  • Journal Title: Clinical Ophthalmology Volume: 11 Pages: 1359-1363
  • DOI: 10.2147/opth.s139751
  • Peer Reviewed / Open Access
• [Journal Article] Rebamipide protects against glaucoma eyedrop-induced ocular surface disorders in rabbits. (2017)
  • Author(s): Kawaguchi I, Kobayashi A, Higashide T, Takeji Y, Sakurai K, Kawaguchi C, Sugiyama K.
  • Journal Title: PLoS One Volume: 12(10) Issue: 10 Pages: e0186714-e0186714
  • DOI: 10.1371/journal.pone.0186714
  • Peer Reviewed / Open Access
• [Presentation] Symposium. Surgical correction of astigmatism during DSAEK for failed penetrating keratoplasty. (2018)
  • Author(s): Kobayashi A
  • Organizer: The 6th Asia Cornea Society Biennial Scientific Meeting
  • Int'l Joint Research / Invited
• [Presentation] Graft management during DMEK using novel graft manipulator. (2018)
  • Author(s): Kobayashi A
  • Organizer: The 6th Asia Cornea Society Biennial Scientific Meeting
  • Int'l Joint Research / Invited
• [Presentation] A 10-year review of underlying diseases for endothelial keratoplasty (DSAEK/DMEK) in a tertiary referral hospital in Japan (2018)
  • Author(s): Kobayashi A, Nishino T, Yokogawa H, Mori N, Masaki T, Sugiyama K.
  • Organizer: Association for Reserch in Vision and Ophthalmology
  • Int'l Joint Research
• [Presentation] Genetic analysis and in vivo histology of Meesmann epithelial corneal dystrophy. (2018)
  • Author(s): Nishino T, Kobayashi A, Mori N, Masaki T, Yokogawa H, Fujiki K, Yanagawa A, Murakami A, Sugiyama K.
  • Organizer: Association for Reserch in Vision and Ophthalmology
  • Int'l Joint Research
• [Presentation] De novo iris abnormality after Descemet membrane endothelial keratoplasty and its impact on postoperative clinical outcomes. (2018)
  • Author(s): Yokogawa H, Kobayashi A, Mori N, Nishino T, Masaki T, Sugiyama K
  • Organizer: Association for Reserch in Vision and Ophthalmology
  • Int'l Joint Research
• [Presentation] Intraoperative OCT (iOCT) using RESCAN700 for DSAEK/DMEK (2018)
  • Author(s): Kobayashi A
  • Organizer: The 33rd Asia-Pacific Academy of Ophthalmology Congress
  • Int'l Joint Research
• [Presentation] 短時間で再現性良く行うことが出来るDMEK術式（デスメ膜把持法）の開発 (2018)
  • Author(s): 小林 顕、横川英明、森奈津子、正木利憲、杉山和久
  • Organizer: 角膜カンファランス2018 2018年2月16日 広島市 （グランドプリンスホテル広島）
• [Presentation] DSAEK術後内皮機能不全眼に対する再DSAEK (2018)
  • Author(s): 横川英明、小林 顕、森奈津子、西野翼、正木利憲、杉山和久
  • Organizer: 角膜カンファランス2018 2018年2月16日 広島市 （グランドプリンスホテル広島）
• [Presentation] 過去の全層角膜移植眼に対するDSAEKにおける乱視矯正角膜追加縫合の効果 (2018)
  • Author(s): 正木利憲、小林 顕、横川英明、森奈津子、杉山和久
  • Organizer: 角膜カンファランス2018 2018年2月16日 広島市 （グランドプリンスホテル広島）
• [Presentation] 角膜内皮移植の最前線 (2018)
  • Author(s): 小林 顕
  • Organizer: 第41回日本眼科手術学会総会2018年1月28日 京都 国立京都国際会館
  • Invited
• [Presentation] Intraoperative OCT (iOCT) using RESCAN700 for DSAEK/DMEK (2018)
  • Author(s): Kobayashi A.
  • Organizer: The 33rd Asia-Pacific Academy of Ophthalmology Congress, Feb 9, 2018, Hong Kong. (Hong Kong Convention & Exhibition Centre)
  • Invited
• [Presentation] 角膜内皮移植を極める DSAEKとDMEKの使い分け (2017)
  • Author(s): 小林 顕
  • Organizer: 第40回日本眼科手術学会総会
  • Place of Presentation: 東京都 （東京国際フォーラム）
  • Year and Date: 2017-01-27
  • Invited