湿房和深低温保存角膜穿透性移植术后角膜内皮分析

Specular microscopic analysis on penetration keratoplasty with moist-chamber storaged or long-term cryopreserved corneas

目的 探讨深低温长期保存和短期湿房保存角膜移植术后植片角膜内皮细胞形态学特征。方法 应用深低温长期保存 30～ 5 0个月 (平均 2 5 .0± 11.9个月 )青壮年供体眼角膜完成穿透性角膜移植 2 4例 (2 4只眼 ) ,同时与来自于青壮年供体经 4℃湿房保存的新鲜供眼角膜穿透性移植术后的角膜内皮细胞状况相比较。全部患者术后角膜植片保持透明 ,未曾出现移植免疫排斥反应 ,手术操作由同一医生完成。术后 2～ 2 0 (平均 6 .7± 3.1)个月应用接触式角膜内皮显微镜及与其同步显示的角膜内皮细胞分析仪对角膜植片中央内皮细胞进行观察和分析。结果 应用深低温保存和湿房保存角膜行穿透性角膜移植术后角膜内皮细胞平均面积、细胞平均密度、面积变异系数、细胞最大面积、细胞最小面积以及六角形细胞出现率间均无显著性差异 (t=0 .116～ 1.195 ,P >0 .0 5 )。

Objective To study corneal endothelial cells on penetrating keratoplasty with moist chamber storaged or long term cryopreserved corneas.Methods 42 cases(42 eyes) were performed penetrating keratoplasty with young human cadaver corneas undergoing cryopreserved for 30 days to 50 (means 25±11.9) months or short term moist chamber storage.The Kaufman Ca pella cryopreservation technique was used.All transplants were clear,and rejection doesn't occurred postoperatively.All corneal transplantations performed by one surgeon.The periods of analysising corneal endothelium with specular microscope EM 1000 and corneal endothelium cell analyzer EM 1020 were 2 to 20(mean,6.7±3.1) months postoperatively.Results There were no difference between conreal endothelial cells on penetrating keratoplasty using long term cryopreserved corneas and those of using moist chamber storaged on the average area,cell density,area CV,maximum cell area,minimum cell area and the frequency of hexagonal cells(t=0.116～1.195,P>0 05).Conclusion Long term cryopreserved cornea is very usefull on penetrating keratoplasty.