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角膜移植术后供体角膜内皮细胞的变化 被引量:3

Variation of corneal endothelium of donor with keratoplasty
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摘要 目的用角膜内皮显微镜对穿透性角膜移植的供眼及术后移植片定期进行内皮细胞摄相观察,探讨供眼角膜内皮细胞的变异情况以及影响其变异的因素。方法选择做穿透性角膜移植的15例病人,用角膜内皮显微镜对术前供眼及术后植片进行定期内皮细胞密度、平均细胞面积、细胞大小变异系数(CV值)及细胞形态方面检查分析。结果(1)术后2~6周、3~6个月、7~11个月及1~1.5年的内皮细胞丧失率分别为12.17%、21.91%、26.55%及29.28%。(2)供眼角膜内皮细胞的平均细胞面积由术前的457.06μm2逐渐增加到术后1~1.5年的646.34μm2,CV值由52.42%增加到62.32%。(3)供眼六角形内皮细胞的比率由术前的41.76%下降到术后1~1.5年的28.08%。结论穿透性角膜移植术后供眼角膜内皮细胞密度逐渐减少,细胞丧失率逐渐增大,术后3~6个月增大最明显,7~11个月变化较小,趋于稳定。平均细胞面积及细胞大小变异系数均逐渐增大。标准的六角形细胞比例则逐渐变小,非六角形细胞的比例相应增大。穿透性角膜移植术后,植片均能透明愈合,且角膜厚度在正常范围内,并获得良好视力,因此其是使角膜病失明患者复明的重要手段。 Objective To investigate changes in the human corneal endothelium of donor eyeballs and postoperative grafts with advanced wild field specular microscope.Methods Endothelial cell density(ECD),average cell area,coefficient of variation of cell area(CV) and percentage of hexagonal cell were compared for 15 donor corneas that underwent a penetrating keratoplasty.The preoperative data were compared with those obtained in postoperative 2~6 weeks,3~6 months,7~11 months and 1~1.5 years.Results (1)The loss rates of the corneal endothelium were 12.17%,21.91%,26.55% and 29.28% in postoperative 2~6 weeks,3~6 months,7~11 months and 1~1.5 years respectively.(2)The average cell area of the donor corneal endothelium increased from preoperative 457.06μm^2 to 646.34μm\+2 in 1~1.5 years postoperatively.The CV increased from 52.42% to 62.32%.(3)The percentage of hexagonal cells of donor corneal endothelium decreased from 41.74% to 28.08% after operation 1~1.5 years.Conclusions (1)After penetrating keratoplasty,the density of donor corneal endothelium decreased,but the loss rates of corneal endothelium increased especially after operation 3~6 months,and did less postoperatively 7~11 months.The average cell area and CV increased gradually.The percentage of standard hexagonal clls decreased and the non-hexagonal cells increased.(2)All grafts were transparent,and corneal thickness was in the normal range,and had good correct acuity vision on penetrating keratoplasty.So that operation is important means for treating corenal leucoma and other diseases.
作者 肖琼 黄菊天
出处 《中国实用眼科杂志》 CSCD 北大核心 2005年第5期499-501,共3页 Chinese Journal of Practical Ophthalmology
关键词 角膜移植术 供体角膜 内皮细胞 细胞形态 角膜厚度 Corneal endothelium Specular microscope Penetrating keratoplasty
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参考文献10

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同被引文献13

  • 1黄挺,陈家祺,刘祖国,陈龙山.全角膜穿透性移植术后部分穿透性移植术治疗严重全角膜病变[J].中国实用眼科杂志,2005,23(3):224-229. 被引量:6
  • 2蒋云海,胡竹林,刘海.穿透性角膜移植术128例临床分析[J].中国实用眼科杂志,2006,24(4):379-380. 被引量:6
  • 3Ohguro N, Matsuda M, Kinoshita S. Effects of posterior chamber lens implantation on the endothelium of transplanted corneas [ J ]. Br J Ophthalmol, 1997,81 (12) : 1056-1059.
  • 4Gallemore RP, McCuen BW. Silicone Oil in vitreoretinal sur- gery. In: Ryan SJ, Wilkinson CP eds. Retina[M] (4th edition). St. Louis : Mosby, 2006 : 2211-2234.
  • 5Silicone Study Group.Silicone Study report 7. The incidence of corneal abnormalities in the silicone study:results of a random- ized clinical trial [ J]. Arch Ophthalmol, 1995,113:764-769.
  • 6Karel I, Kalvodova B, Kuthan P. Results of penetrating kerato- plasty in bullous silicone oil keratopathy[J].Graefe's Arch Clin Exp Ophthalmol, 1998,236:255-258.
  • 7Lee GA, Shah P, Cooling R J, et al. Penetrating keratoplasty for silicone oil keratopathy [J]. Clin Exp Ophthalmol, 2001, 29: 303-306.
  • 8Roters S,Hamzei P,Szurman P,et al. Combined penetrating ker- atoplasty and vitreoretinal surgery with silicone oil: a 1 year fol- low-up [J]. Graefes Arch Clin Exp Ophthalmol, 2003, 241: 24-33.
  • 9坑彩霞.角膜移植术后免疫排斥反应的药物治疗[J].眼外伤职业眼病杂志,2008,30(5):382-384. 被引量:4
  • 10吴护平,刘祖国,刘昭升,蔡锦红,陈燕.穿透性角膜移植术治疗硅油填充术后角膜病变的初步研究[J].中华眼科杂志,2009,45(1):73-75. 被引量:1

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