Borderie Vincent M, Touzeau Olivier, Bourcier Tristan, Allouch Cécile, Laroche Laurent
Department of Ophthalmology, Centre Hospitalier National d'Ophtalmologie des XV-XX, Paris VI University, Paris, France.
Ophthalmology. 2006 Dec;113(12):2181-6. doi: 10.1016/j.ophtha.2006.06.020. Epub 2006 Sep 25.
To analyze graft reepithelialization after penetrating keratoplasty using organ-cultured donor tissue.
Retrospective observational cohort study.
One thousand one hundred thirty-eight consecutive penetrating keratoplasties (1003 patients) performed between 1992 and 2004 were analyzed, and 1003 were included (1 graft per patient was included).
Slit-lamp examination after fluorescein staining.
Graft reepithelialization time was recorded.
The average graft reepithelialization time was 4.6+/-13.2 days (range, 1-210 days; median, 2.5 days). Complete corneal epithelial healing was obtained in 1 day in 28.5% of patients, in 3 days in 65.8%, in 7 days in 93.6%, and in 14 days in 97.0%. Postoperative chronic epithelial defects occurred in 3.0% of patients. In univariate analysis, death-to-storage time, storage time, deswelling time, rejection risk, trephination size, suture method, use of dexamethasone ointment during surgery, use of sodium hyaluronate during surgery, and use of high postoperative steroid regimen significantly influenced the graft reepithelialization time (P<0.05). In multiple regression, only the rejection risk (beta = 0.07; P = 0.045), use of sodium hyaluronate at the end of surgery (beta = -0.17; P = 0.001), and steroid regimen (beta = 0.09; P = 0.022) significantly influenced the graft reepithelialization time.
The use of sodium hyaluronate at the end of surgery to coat the ocular surface shortened graft reepithelialization time after penetrating keratoplasty using organ-cultured donor tissue. Graft reepithelialization time was longer in high-risk recipients, and it increased with high dexamethasone eyedrops regimen.
分析使用器官培养供体组织进行穿透性角膜移植术后植片的再上皮化情况。
回顾性观察队列研究。
分析了1992年至2004年间连续进行的1138例穿透性角膜移植术（1003例患者），纳入1003例（每位患者纳入1片植片）。
荧光素染色后裂隙灯检查。
记录植片再上皮化时间。
植片平均再上皮化时间为4.6±13.2天（范围1 - 210天；中位数2.5天）。28.5%的患者在1天内实现角膜上皮完全愈合，65.8%在3天内，93.6%在7天内，97.0%在14天内。3.0%的患者术后出现慢性上皮缺损。单因素分析中，死亡至保存时间、保存时间、消肿时间拒绝风险、环钻大小、缝合方法、术中使用地塞米松眼膏、术中使用透明质酸钠以及术后高剂量类固醇方案对植片再上皮化时间有显著影响（P<0.05）。多因素回归分析中，仅拒绝风险（β = 0.07；P = 0.045）、术末使用透明质酸钠（β = -0.17；P = 0.001）和类固醇方案（β = 0.09；P = 0.022）对植片再上皮化时间有显著影响。
术末使用透明质酸钠覆盖眼表可缩短使用器官培养供体组织进行穿透性角膜移植术后植片的再上皮化时间。高危受者的植片再上皮化时间较长，且高剂量地塞米松滴眼液方案会使其延长。
