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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">helmholtzeyeinstitute</journal-id><journal-title-group><journal-title xml:lang="ru">Российский офтальмологический журнал</journal-title><trans-title-group xml:lang="en"><trans-title>Russian Ophthalmological Journal</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2072-0076</issn><issn pub-type="epub">2587-5760</issn><publisher><publisher-name>Real time Publishers</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21516/2072-0076-2018-11-3-11-18</article-id><article-id custom-type="elpub" pub-id-type="custom">helmholtzeyeinstitute-164</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>КЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CLINICAL STUDIES</subject></subj-group></article-categories><title-group><article-title>НОВАЯ СТРАТЕГИЯ КЕРАТОПЛАСТИКИ: РАССЛОЕНИЕ И РАЗДЕЛЕНИЕ РОГОВИЦЫ ДОНОРА</article-title><trans-title-group xml:lang="en"><trans-title>A NEW STRATEGY OF KERATOPLASTY: LAMINATING AND SPLITTING THE DONOR CORNEA</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Оганесян</surname><given-names>О. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Oganesyan</surname><given-names>O. G.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Макаров</surname><given-names>П. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Makarov</surname><given-names>P. V.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Грдиканян</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Grdikanyan</surname><given-names>A. A.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гетадарян</surname><given-names>В. Р.</given-names></name><name name-style="western" xml:lang="en"><surname>Getadaryan</surname><given-names>V. R.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБУ "Московский НИИ глазных болезней им. Гельмгольца" Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Moscow Helmholtz Research Institute of Eye Diseases</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2018</year></pub-date><pub-date pub-type="epub"><day>03</day><month>10</month><year>2018</year></pub-date><volume>11</volume><issue>3</issue><fpage>11</fpage><lpage>18</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Оганесян О.Г., Макаров П.В., Грдиканян А.А., Гетадарян В.Р., 2018</copyright-statement><copyright-year>2018</copyright-year><copyright-holder xml:lang="ru">Оганесян О.Г., Макаров П.В., Грдиканян А.А., Гетадарян В.Р.</copyright-holder><copyright-holder xml:lang="en">Oganesyan O.G., Makarov P.V., Grdikanyan A.A., Getadaryan V.R.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://roj.igb.ru/jour/article/view/164">https://roj.igb.ru/jour/article/view/164</self-uri><abstract/><trans-abstract xml:lang="en"><p>Purpose: to report the first case of the same day use of a single donor cornea tissue for 5 consecutive transplantations in patients with endothelial dystrophy and keratoconus. Material and methods. The Descemet membrane (DM) and the endothelium were fully detached from the stroma of the donor on the endothelial side, using first a circular and then a direct corneal cutter, forming four partial triangle-shaped Descemet grafts (each constituted a 1/4 Descemet graft). The stroma of the donor's cornea was separated by a circular cutter of a preset diameter. One patient with keratoconus underwent deep anterior lamellar keratoplasty (DALK) using the big bubble technique. Then, each of the four Descemet grafts was sequentially transplanted by the Descemet membrane endothelial keratoplasty (DMEK) method to 4 patients with Fuchs dystrophy and pseudophakia. Results. During and after the surgery, there were no complications requiring additional intervention. Six months after DALK, the best corrected visual acuity (BCVA) was 0.66. Six months after four operations each using ¼ DMEK the average BCVA was 0.95 ± 0.1 (from 0.8 to 1.0) and the endothelial cell density was, respectively, 2839 after DALK and 1680 ± 254 cells/mm2 (from 1492 to 2039 cells/mm2) after ¼ DMEK. Conclusion. One donor cornea can be successfully transplanted to at least 5 patients. Despite the fact that the implementation of DALK and several operations using the ¼ DMEK technique within one day is technically difficult, this approach can contribute to a drastic reduction in the deficit of donor tissue. This approach requires a thorough selection of patients and an extensive surgical experience. For citation: Oganesyan O.G., Makarov P.V., Grdikanyan А.А., Getadaryan V.R. A new strategy of keratoplasty: laminating and splitting the donor cornea. Russian ophthalmological journal. 2018; 11 (3): 11-8 (In Russian). doi: 10.21516/2072-0076-2018-11-3-11-18. The full English version is available online at http://roj.igb.ru/eng/issues</p></trans-abstract><kwd-group xml:lang="ru"><kwd>роговица донора</kwd><kwd>кератопластика</kwd><kwd>трансплантация роговицы</kwd><kwd>трансплантация десцеметовой мембраны</kwd><kwd>DMEK</kwd><kwd>Q-DMEK</kwd><kwd>¼ DMEK</kwd><kwd>donor cornea</kwd><kwd>keratoplasty</kwd><kwd>corneal transplantation</kwd><kwd>Descemet membrane transplantation</kwd><kwd>DMEK</kwd><kwd>Q-DMEK</kwd><kwd>¼ DMEK</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Phillips P., Terry M., Shamie N. et al. Descemet’s stripping automated endothelial keratoplasty (DSAEK) using corneal donor tissue not acceptable for use in penetrating keratoplasty as a result of anterior stromal scars, pterygia, and previous corneal refractive surgical procedures. 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