不同受者同期分别接受同者的角膜移植五例

Two corneal donor tissues for 5 different recipients

目的为提高角膜材料的利用率，探讨将同一噶供者的二个角膜同期移植给不同受者的可行性及手术方法。方法供者的其中一个角膜材料分别为1例角结膜恶性黑色素瘤，1例蚕蚀性角膜溃疡伴穿孔行前部分板层角膜移植术，并对1例大泡性角膜病变行深板层角膜内皮移植术。另一个角膜材料分别为眼烧伤后重度睑球粘连行全板层角膜移植和1例大泡性角膜病变行深板层角膜内皮移植术。结果5例角膜病患者手术均获得成功，其中2例大泡性角膜病变患者术后1个月，角膜上皮水泡消失，角膜水肿减轻，内皮植片透明。1例角结膜恶性黑色素瘤患者，视力术前0．3提高至术后0．6，植片透明，角膜植床及结膜无色素残留。1例蚕蚀性角膜伴穿孔经羊膜移植联合部分板层角膜移植治愈。1例眼烧伤睑球粘连患者，术后1个月，睑球粘连完全解除，植片透明，视力由术前0．1提高到0．3。结论将同一供者的角膜分别移植给不同受者，能充分利用供者角膜材料，方法可行，效果良好。

Objective To evaluate the feasibility and to discuss the methods of using two donor corneal tissue in multiple patients. Methods One donor corneal tissue was divided into 3 parts： The anterior lamellar part were transplanted into a patient with corneo-conjunctival malignant melanoma and a patient with corneal perforation of Mooren＇s ulcer using lamellar keratoplasty technique; The posterior part was transplanted into a patient with bullous keratopathy using deep lamellar endothelial keratoplasty technique. The other donor corneal tissue was divided into 2 parts： The anterior part was transplanted into a patient with severe symblepharon after ocular surface thermal burn using full bed lamellar keratoplasty. The posterior part was transplanted into another patient with bullous keratopathy using deep lamellar endothelial keratoplasty technique. Results All surgical procedures were.performed successfully. At 1 month after surgery, the grafts were transparent in both of the eyes with bullous keratopathy. Epithelial bulla disappeared and cornea edema relieved in both cornea. The best corrected visual acuity of the patient with corneo-conjunctival malignant melanoma improved from 0.3 preoperatively to 0.6 postoperatively. The graft remained transparent and no pigment remained in the conjunctiva and graft bed of recipient. The patient with corneal perforation of Mooren＇s ulcer were cured after amniotic membrane transplantation combined with partial lamellar keratoplasty. At 1 month, the best corrected visual acuity was improved from 0.1 preoperetively to 0.3 postoperatively in the patient with severe symblepharon. The graft remained transparent and the symblepharon was relieved. Conclusion To make good use of donor cornea, we can use one donor cornea to treat multiple patients.