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In vivo analysis of the cornea after DMEK

Research Project

Project/Area Number 19K09947
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Review Section Basic Section 56060:Ophthalmology-related
Research InstitutionKanazawa University

Principal Investigator

Kobayashi Akira  金沢大学, 附属病院, 講師 (20303274)

Project Period (FY) 2019-04-01 – 2022-03-31
Project Status Completed (Fiscal Year 2021)
Budget Amount *help
¥4,290,000 (Direct Cost: ¥3,300,000、Indirect Cost: ¥990,000)
Fiscal Year 2021: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
Fiscal Year 2020: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
Fiscal Year 2019: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
Keywords角膜内皮移植 / レーザー共焦点顕微鏡 / 前眼部光干渉断層計 / DSAEK / DMEK / Endothelial keratoplasty / confocal microscopy
Outline of Research at the Start

本研究では、第一にデスメ膜と角膜内皮細胞層のみからなる角膜内皮シートを移植する角膜内皮移植術(DMEK)と新しく発見された角膜層であるDua層と内皮層を移植するPDEK術式の確立を行う。これらの術式は術後の視機能は極めて良好であり、拒絶反応がみられないメリットを有するものの、アジア人の眼の構造では技術的な難易度が極めて高いため、安定した術後成績を得るためのノウハウの獲得と専用器具の開発が求められている。第二に、DMEK/PDED術後角膜における微細な生体構造や角膜厚を含む角膜形状の異常について、レーザー共焦点顕微鏡や新型前眼部光干渉断層計などを用いた生体解析を行う。

Outline of Final Research Achievements

In this study, in vivo analysis of the cornea after DMEK was performed using laser in vivo laser comfocal microscopy and anterior segment OCT. As a result, central corneal thinning after DMEK was confirmed. Also, after the corneal epithelial removal, reduction of corneal nerves after DMEK was observed. With the help of Inami company, we developed new device for DMEK that enabled faster and safer surgeries. Also, using Ngenuity 3D visual system, new DMEK surgery is now possible with less intra- and postoperative complications.

Academic Significance and Societal Importance of the Research Achievements

本研究の学術的な特色の第一は、本邦で最多数と思われる角膜内皮移植のこれまでの症例や経験を生かし、日本人における術中術後合併症の種類や発症頻度などについて明らかになった。また、アジア人特有の術中術後合併症を克服するための新たな術式の開発や専用器具の開発を行い、より安全な角膜内皮移植術(DMEK)が可能となった。また、レーザー生体共焦点顕微鏡や新型前眼部OCT、OCT手術顕微鏡等を駆使して、角膜内皮移植術後角膜組織の詳細な生体解析を行った。さらに、DMEK対するNGENUITY3Dビジュアルシステムの有用性が確認された。

Report

(4 results)
  • 2021 Annual Research Report   Final Research Report ( PDF )
  • 2020 Research-status Report
  • 2019 Research-status Report
  • Research Products

    (43 results)

All 2022 2021 2020 2019

All Journal Article (13 results) (of which Peer Reviewed: 13 results,  Open Access: 2 results) Presentation (30 results) (of which Int'l Joint Research: 5 results,  Invited: 8 results)

  • [Journal Article] Intraoperative optical coherence tomography-guided nanothin Descemet stripping automated endothelial keratoplasty in a patient with a remarkably thickened cornea2022

    • Author(s)
      Yokogawa H, Kobayashi A, Mori N, Nishino T, Nozaki H, Sugiyama K.
    • Journal Title

      Am J Ophthalmol Case Rep

      Volume: 25 Pages: 101414-101414

    • DOI

      10.1016/j.ajoc.2022.101414

    • Related Report
      2021 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Aqueous humour cytokine profiles after Descemet's membrane endothelial keratoplasty.2021

    • Author(s)
      Hayashi T, Takahashi H, Inoda S, Shimizu T, Kobayashi A, Kawashima H, Yamaguchi T, Yamagami S.
    • Journal Title

      Scientific report

      Volume: 11 Issue: 1 Pages: 17064-17064

    • DOI

      10.1038/s41598-021-96566-3

    • Related Report
      2021 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Long-term outcomes of Descemet stripping automated endothelial keratoplasty for bullous keratopathy after argon laser iridotomy2021

    • Author(s)
      Ye Y, Mori N, Kobayashi A, Yokogawa H, Sugiyama K
    • Journal Title

      Japanese journal of ophthalmology

      Volume: 65 Issue: 4 Pages: 454-459

    • DOI

      10.1007/s10384-021-00832-w

    • NAID

      40022621213

    • Related Report
      2021 Annual Research Report 2020 Research-status Report
    • Peer Reviewed
  • [Journal Article] Factors associated with endothelial cell density loss post Descemet membrane endothelial keratoplasty for bullous keratopathy in Asia2020

    • Author(s)
      Inoda Satoru、Hayashi Takahiko、Takahashi Hidenori、Oyakawa Itaru、Yokogawa Hideaki、Kobayashi Akira、Kato Naoko、Kawashima Hidetoshi
    • Journal Title

      PLOS ONE

      Volume: 15 Issue: 6 Pages: e0234202-e0234202

    • DOI

      10.1371/journal.pone.0234202

    • Related Report
      2020 Research-status Report
    • Peer Reviewed
  • [Journal Article] <p>Visibility of the Retina Through an Air-Filled Anterior Chamber During Simultaneous Vitrectomy and Descemet’s Stripping Automated Endothelial Keratoplasty</p>2020

    • Author(s)
      Yokogawa Hideaki、Kobayashi Akira、Mori Natsuko、Nishino Tsubasa、Sugiyama Kazuhisa
    • Journal Title

      Clinical Ophthalmology

      Volume: Volume 14 Pages: 2119-2123

    • DOI

      10.2147/opth.s262403

    • Related Report
      2020 Research-status Report
    • Peer Reviewed
  • [Journal Article] Graft Edge Reflection of a Tightly Scrolled Roll Using Endoillumination as a Simple Method for Determining Graft Orientation in Descemet Membrane Endothelial Keratoplasty2020

    • Author(s)
      Kobayashi Akira、Yokogawa Hideaki、Mori Natsuko、Nishino Tsubasa、Sugiyama Kazuhisa
    • Journal Title

      Cornea

      Volume: 40 Issue: 2 Pages: 254-257

    • DOI

      10.1097/ico.0000000000002459

    • Related Report
      2020 Research-status Report
    • Peer Reviewed
  • [Journal Article] <p>In vivo Imaging of Reis?B?cklers and Thiel?Behnke Corneal Dystrophies Using Anterior Segment Optical Coherence Tomography</p>2020

    • Author(s)
      Nishino Tsubasa、Kobayashi Akira、Mori Natsuko、Yokogawa Hideaki、Sugiyama Kazuhisa
    • Journal Title

      Clinical Ophthalmology

      Volume: Volume 14 Pages: 2601-2607

    • DOI

      10.2147/opth.s265136

    • Related Report
      2020 Research-status Report
    • Peer Reviewed
  • [Journal Article] Optical characteristics after Descemet membrane endothelial keratoplasty: 1-year results2020

    • Author(s)
      Hayashi Takahiko、Kobayashi Akira、Takahashi Hidenori、Oyakawa Itaru、Kato Naoko、Yamaguchi Takefumi
    • Journal Title

      PLOS ONE

      Volume: 15 Issue: 10 Pages: e0240458-e0240458

    • DOI

      10.1371/journal.pone.0240458

    • Related Report
      2020 Research-status Report
    • Peer Reviewed
  • [Journal Article] Clinical Evaluation of Electrolysis for Reis-Bucklers Corneal Dystrophies and In Vivo Histological Analysis Using Anterior Segment Optical Coherence Tomography2020

    • Author(s)
      Nishino Tsubasa、Kobayashi Akira、Mori Natsuko、Yokogawa Hideaki、Sugiyama Kazuhisa
    • Journal Title

      Cornea

      Volume: Publish Ahead of Print Issue: 8 Pages: 958-962

    • DOI

      10.1097/ico.0000000000002541

    • Related Report
      2020 Research-status Report
    • Peer Reviewed
  • [Journal Article] Changing indications and surgical techniques for keratoplasty during a 16-year period (2003?2018) at a tertiary referral hospital in Japan2019

    • Author(s)
      Nishino Tsubasa、Kobayashi Akira、Yokogawa Hideaki、Mori Natsuko、Sugiyama Kazuhisa
    • Journal Title

      Clinical Ophthalmology

      Volume: Volume 13 Pages: 1499-1509

    • DOI

      10.2147/opth.s214515

    • Related Report
      2019 Research-status Report
    • Peer Reviewed
  • [Journal Article] Surgery-induced iris abnormalities after Descemet membrane endothelial keratoplasty and their impact on postoperative clinical outcomes2019

    • Author(s)
      Mori Natsuko、Yokogawa Hideaki、Kobayashi Akira、Nishino Tsubasa、Sugiyama Kazuhisa
    • Journal Title

      Clinical Ophthalmology

      Volume: Volume 13 Pages: 805-809

    • DOI

      10.2147/opth.s196906

    • Related Report
      2019 Research-status Report
    • Peer Reviewed
  • [Journal Article] Risk factors for Cystoid Macular Edema After Descemet Membrane Endothelial Keratoplasty2019

    • 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

    • Related Report
      2019 Research-status Report
    • Peer Reviewed
  • [Journal Article] Clinical Evaluation of the NS Endo-Inserter, a Novel Donor Inserter for Descemet’s Stripping Automated Endothelial Keratoplasty2019

    • Author(s)
      Kobayashi Akira、Yokogawa Hideaki、Mori Natsuko、Nishino Tsubasa、Sugiyama Kazuhisa
    • Journal Title

      Case Reports in Ophthalmology

      Volume: 10 Issue: 3 Pages: 357-364

    • DOI

      10.1159/000503441

    • Related Report
      2019 Research-status Report
    • Peer Reviewed
  • [Presentation] Intraoperative OCT-guided nanothin DSAEK for advanced bullous keratopathy.2021

    • Author(s)
      Yokogawa H, Kobayashi A, Mori N, Nishino T, Nozaki H, Sugiyama K
    • Organizer
      The 7th Asia Cornea Society Biennial Scientific Meeting
    • Related Report
      2021 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Two cases of severe corneal damage after administration of anti-TNF-alpha preparation.2021

    • Author(s)
      Mori N, Kobayashi A, Yokogawa H, Nishino T, Sugiyama K.
    • Organizer
      The 7th Asia Cornea Society Biennial Scientific Meeting
    • Related Report
      2021 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Electrolysis for a homozygous Japanese patient with granular corneal dystrophy type 22021

    • Author(s)
      Nishino T, Kobayashi A, Yokogawa H, Mori N, Sugyama K.
    • Organizer
      The 7th Asia Cornea Society Biennial Scientific Meeting
    • Related Report
      2021 Annual Research Report
    • Int'l Joint Research
  • [Presentation] Endoilluminator in DMEK2021

    • Author(s)
      Kobayashi A
    • Organizer
      The 7th Asia Cornea Society Biennial Scientific Meeting
    • Related Report
      2021 Annual Research Report
    • Int'l Joint Research / Invited
  • [Presentation] In vivo imaging of corneal dystrophies2021

    • Author(s)
      Kobayashi A
    • Organizer
      The 36th Asia Pacific Academy of Ophthalmology Congress
    • Related Report
      2021 Annual Research Report
    • Int'l Joint Research / Invited
  • [Presentation] 丸まったDMEKグラフトの裏表を光源を使用して見分ける簡単な方法2020

    • Author(s)
      小林 顕、横川英明、森 奈津子、西野 翼、杉山和久
    • Organizer
      角膜カンファランス 2020
    • Related Report
      2020 Research-status Report
  • [Presentation] タクロリムス点眼継続中に発症した劇症型サイトメガロウイルス角膜内皮炎2020

    • Author(s)
      横川英明、小林顕、竹本裕子、森 奈津子、輪島良太郎西野 翼、杉山和久
    • Organizer
      角膜カンファランス 2020
    • Related Report
      2020 Research-status Report
  • [Presentation] Reis-Bucklers角膜ジストロフィに対する角膜電気分解の有用性2020

    • Author(s)
      西野 翼、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 2020
    • Related Report
      2020 Research-status Report
  • [Presentation] 前眼部OCTを用いたReis-Bucklers角膜ジストロフィに対する角膜電気分解の評価2020

    • Author(s)
      西野 翼、小林顕、横川英明、森 奈津子、杉山和久
    • Organizer
      第74回日本臨床眼科学会
    • Related Report
      2020 Research-status Report
  • [Presentation] 角膜移植の温故知新 角膜内皮移植2020

    • Author(s)
      小林 顕
    • Organizer
      第124回日本眼科学会総会
    • Related Report
      2020 Research-status Report
    • Invited
  • [Presentation] DMEKを始めよう 日本人眼に対するDMEKの工夫2020

    • Author(s)
      小林 顕
    • Organizer
      第43回日本眼科手術学会総会
    • Related Report
      2020 Research-status Report
    • Invited
  • [Presentation] DSAEK and DMEK for Asian eyes2020

    • Author(s)
      Akira Kobayashi
    • Organizer
      第74回日本臨床眼科学会
    • Related Report
      2020 Research-status Report
    • Invited
  • [Presentation] 緑内障を伴う眼の角膜移植術2020

    • Author(s)
      小林 顕
    • Organizer
      第31回日本緑内障学会
    • Related Report
      2020 Research-status Report
    • Invited
  • [Presentation] 角膜内皮疾患治療の進歩2020

    • Author(s)
      小林 顕
    • Organizer
      第72回眼科専門医制度講習会
    • Related Report
      2020 Research-status Report
    • Invited
  • [Presentation] 角膜内皮疾患治療の進歩 (特別講演)2020

    • Author(s)
      小林 顕
    • Organizer
      第109回秋田眼科集談会
    • Related Report
      2020 Research-status Report
    • Invited
  • [Presentation] 緑内障眼に合併した水疱性角膜症に対する角膜内皮移植の術後経過に影響を与える因子2019

    • Author(s)
      狩野愛佳, 東出朋巳, 満保祐己, 西野翼, 横川英明, 小林顕, 杉山和久
    • Organizer
      第123回 日本眼科学会総会
    • Related Report
      2019 Research-status Report
  • [Presentation] 緑内障濾過胞眼症例における角膜内皮移植術後の内皮細胞密度の経過2019

    • Author(s)
      竹森 勇人, 東出 朋巳, 正木 利憲, 横川 英明, 小林 顕, 杉山 和久
    • Organizer
      第123回 日本眼科学会総会
    • Related Report
      2019 Research-status Report
  • [Presentation] NS Endo-Inserterを用いたDSAEK:多様な原疾患での検討2019

    • Author(s)
      小林 顕
    • Organizer
      第123回 日本眼科学会総会
    • Related Report
      2019 Research-status Report
  • [Presentation] Clinical evaluation of NS Endo-Inserter, a novel donor inserter for Descemet’s Stripping Automated Endothelial Keratoplasty.2019

    • Author(s)
      Kobayashi A, Yokogawa H, Mori N, Nishino T, Sugiyama K
    • Organizer
      Association for Reserch in Vision and Ophthalmology, Vancouver, Canada
    • Related Report
      2019 Research-status Report
  • [Presentation] Clinical evaluation of lifeline suture technique for DSAEK in cases without posterior capsule using novel donor insertion device (NS Endo-Inserter)2019

    • Author(s)
      Yokogawa H, Kobayashi A, Mori N, Nishino T, Sugiyama K
    • Organizer
      Association for Reserch in Vision and Ophthalmology
    • Related Report
      2019 Research-status Report
  • [Presentation] In vivo imaging of Bowman’s layer dystrophies (Reis-B&uuml;cklers and Thiel-Behnke corneal dystrophies) using anterior segment optical coherence tomography.2019

    • Author(s)
      Nishino T, Kobayashi A, Yokogawa H, Mori N, Sugiyama K
    • Organizer
      Association for Reserch in Vision and Ophthalmology
    • Related Report
      2019 Research-status Report
  • [Presentation] 硝子体手術後水疱性角膜症に対するDouble bubble techniqueを用いたDMEK治療の検討2019

    • Author(s)
      親川 格, 山崎 梨沙, 小林 顕, 林 孝彦
    • Organizer
      第89回九州眼科学会
    • Related Report
      2019 Research-status Report
  • [Presentation] Cystoid macular edema following staged Descemet’s Membrane Endothelial Keratoplasty in Asian Eyes2019

    • Author(s)
      Satoru T. Hayashi, H. Takahashi, I. Oyakawa, H. Yokogawa, A. Kobayashi, N. Kato, H.Kawashima
    • Organizer
      Association for Reserch in Vision and Ophthalmology
    • Related Report
      2019 Research-status Report
  • [Presentation] One year outcome of Descemet’s stripping automated endothelial keratoplasty for Asian eyes2019

    • Author(s)
      Hayashi T, Inoda S, Takahashi H, Oyakawa I, Yokogawa H, Kobayashi A, Kato N
    • Organizer
      Eucornea Congress
    • Related Report
      2019 Research-status Report
  • [Presentation] Descemet’s membrane endothelial keratoplasty for complex eyes.2019

    • Author(s)
      Hayashi T, Kobayashi A, Oyakawa I, Yamazaki K, Kato N
    • Organizer
      Eucornea Congress
    • Related Report
      2019 Research-status Report
  • [Presentation] Clinical evaluation of NS Endo-Inserter, a novel donor inserter for Descemet’s Stripping Automated Endothelial Keratoplasty2019

    • Author(s)
      Kobayashi A, Yokogawa H, Mori N, Nishino T, Sugiyama K
    • Organizer
      The 12th Joint Meeting of Chinese-Japanese-Korean Ophthalmologists
    • Related Report
      2019 Research-status Report
  • [Presentation] Visibility of the retina through air-filled anterior chamber during simultaneous vitrectomy and DSAEK2019

    • Author(s)
      Yokogawa H, Kobayashi A, Mori N, Nishino T, Sugiyama K
    • Organizer
      The 12th Joint Meeting of Chinese-Japanese-Korean Ophthalmologists
    • Related Report
      2019 Research-status Report
  • [Presentation] SAEKと同時に行う硝子体手術中の眼底視認性の検討2019

    • Author(s)
      横川英明, 小林 顕, 森 奈津子, 西野 翼, 中澤和樹, 奥田徹彦, 杉山和久
    • Organizer
      第73回日本臨床眼科学会 京都市、国立京都国際会館 2019年10月
    • Related Report
      2019 Research-status Report
  • [Presentation] 水疱性角膜症に対するDSAEK術後の角膜内皮細胞密度減少と晩期移植片機能不全の関連因子2019

    • Author(s)
      竹森勇人, 東出朋巳, 正木利憲, 狩野愛佳, 横川英明, 小林 顕, 杉山和久
    • Organizer
      第73回日本臨床眼科学会
    • Related Report
      2019 Research-status Report
  • [Presentation] 角膜治療:最近の進歩 「角膜内皮移植アップデート」2019

    • Author(s)
      小林 顕
    • Organizer
      第73回日本臨床眼科学会
    • Related Report
      2019 Research-status Report

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Published: 2019-04-18   Modified: 2023-01-30  

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