新型生物组织工程角膜移植治疗犬猫角膜疾病的回顾性分析

A Large Retrospective Study on the Treatment of Corneal Diseases in Dogs and Cats with a New Type of Bioengineered Cornea Transplantation

本研究旨在大型回顾性分析总结新型生物组织工程角膜(biotissue-engineered cornea,BEC)治疗犬猫角膜疾病的手术方法与长期临床效果。本研究回顾了2018—2022年使用BEC进行眼表移植手术并至少跟踪随访3个月及以上的犬猫的医疗记录。包括坏死性角膜炎、深度角膜溃疡、后弹力层膨出以及角膜穿孔在内的犬猫患眼被纳入本研究。术后每周定期检查,并在术后0、3、6和12个月对部分患眼进行了光学相干断层扫描检查,根据最后一次检查结果对术眼角膜进行评级。本研究共纳入139只患眼(猫112例,犬27例),其中板层角膜移植103只眼,全层角膜移植36只眼。使用4种不同厚度的BEC植片(200、300、400和450μm),植片的平均直径为7.74 mm(范围为3~13 mm)。术后影响相对较大的并发症包括植片部分松脱或裂开(5例,3.60%)、植片溶解或穿孔(8例,5.76%)、角膜植床坏死(1例,0.72%)和眼球萎缩(1例,0.72%)。术后随访时间为3~50个月(中位数18个月),最终139只眼均保持了角膜和眼球完整性,其中133只眼(95.68%)保留了较敏锐视力。统计学分析显示,角膜植片透明度与动物年龄(P=0.021)、物种(P=0.000)、植片直径(P=0.032)、是否全层移植(P=0.000)以及角膜再上皮时间(P=0.000)显著正相关。BEC是一种安全且有效的角膜植片,可用于犬猫板层或全层角膜移植术,具有广泛的临床应用价值。

This study was conducted to retrospectively analyze and summarize the surgical methods and long-term clinical effects of the new biotissue-engineered cornea(BEC)in the treatment of corneal diseases in canine and feline.This study reviewed the medical records of canine and feline useing BEC for ocular surface transplantation from 2018 to 2022 and followed up for at least 3 months.The eyes of animals including sequestrum,deep corneal ulcer,descemetocele and corneal perforation were included in the study.The patients were examined regularly every week after surgery,and selected eyes were examined with optical coherence tomography at 0,3,6 and 12 months after surgery.The corneas of the patients were graded according to the results of the last examination.A total of 139 eyes(112 of feline and 27 of canine)were included in this study,including 103 eyes with lamellar keratoplasty and 36 eyes with full-thickness keratoplasty.Four different thicknesses of BEC implants(200,300,400 and 450μm)were used.The average diameter of the graft was 7.74 mm(range:3-13 mm).Postoperative complications with relatively impact included partial graft loosening or dehiscence(5 cases,3.60%),graft dissolution or perforation(8 cases,5.76%),corneal graft bed sequestrum(1 case,0.72%)and atrophia bulbi(1 case,0.72%).The follow-up time spanned 3-50 months(median 18 months).Finally,139 eyes maintained the integrity of cornea and eyeball,and 133 eyes(95.68%)retained relatively sharp vision.Statistical analysis showed that corneal graft transparency was significantly and positively correlated with animal age(P=0.021),species(P=0.000),Graft diameter(P=0.032),full thickness transplantation or not(P=0.000),and corneal re-epithelialization time(P=0.000).BEC is a safe and effective corneal graft,which can be used for lamellar or full-thickness keratoplasty in canine and feline,and has extensive clinical application value.