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פרופ׳ איתן לבני

מומחה ברפואת עיניים ומנתח

צילום ניתוח עיניים

ניתוח השתלת קרנית אחורית בשיטת ה- DMEK (דימק)

ניתוח זה הוא הניתוח המתקדם והמוצלח ביותר שניתן לבצע במטופלים הסובלים מבעיה בתאי הקרנית הפנימיים, הם תאי האנדותל. בניתוח זה מוציאים את התאים החולים מהחלק הפנימי של הקרנית ולאחר מכן המנתח מחליף תאים אלו בשכבה דקיקה המכילה תאים בריאים מהתורם. ניתוח זה הוא ניתוח ללא תפרים (לעומת סוגי ההשתלות האחרות).

ניתוח DMEK נחשב יחסית מורכב מבחינה ניתוחית, אך בידי מנתחים בעלי ניסיון רב – התוצאות בדרך כלל טובות מאוד. במחקרים גדולים שנערכו בעולם נמצא כי חלק ניכר מהמנותחים שנותחו בשיטת DMEK חוזרים די מהר לאחר הניתוח לחדות ראייה של סביב 6/6, בהינתן שאין בעיניהם מחלות אחרות המגבילות את הפוטנציאל הראייתי. אחוז דחיית השתל (REJECTION) בשיטה זו נמוכים בהרבה מאחוז הדחיות בשיטות אחרות ועומדות על כאחוז אחד של סיכון.

ישנם מקרים בהם אין אפשרות להחליף רק את תאי האנדותל בשיטת DMEK, אך עדיין ניתן לבצע השתלה חלקית אחורית של הקרנית. במקרים אלו יבחר המנתח להשתמש בשיטה ניתוחית הנקראת DSAEK: השתלה של פרוסה בעובי של כ-100 מיקרון (עשירית המילימטר) מקרנית התורם – בחלק הפנימי של קרנית המטופל.

השתלות קרנית

ניתוח DMEK

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