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[保存期内裂隙灯及角膜内皮显微镜对角膜组织的评估]

[Evaluation of corneal tissue by slit lamp and specular microscopy during the preservation period].

作者信息

Farias Roberta Jansen de Mello, Kubokawa Karen Miyuki, Schirmer Maurício, Sousa Luciene Barbosa de

机构信息

Universidade Federal de São Paulo, São Paulo, SP, Brazil.

出版信息

Arq Bras Oftalmol. 2007 Jan-Feb;70(1):79-83. doi: 10.1590/s0004-27492007000100015.

Abstract

PURPOSE

To analyze changes evaluation of corneal grafts by slit lamp and electron microscopy examination in order to ensure a donor cornea of good quality level for the patient.

METHODS

203 corneas donated to the Sorocaba Eye Bank between September 2002 and February 2003 were prospectively evaluated. The evaluation was graded from 0 to 3 according to the following factors: exposure and epithelial damage, stromal opacity, Descemet folds, pleomorphism, polymegatism and guttata, endothelial snail track, edema, reflectivity. The data were correlated with time between death and preservation, endothelial cell count and donor's age.

RESULTS

203 corneas were evaluated. The mean age of donors was 55 years (dp= 14.8 years). The mean time between death and preservation was 9.1 h (minimum of 2 h and maximum of 25 h). Eighty-six corneas suffered worsening of evaluation, whereby 66.3% had less than 2,500 endothelial cell count and 59.3% presented time between death and preservation over 6 hours. The mean day of the grading change was the 5th.

CONCLUSIONS

Corneal grafts from younger donors had significantly better evaluation than those of older donors. The mean time of the evaluation change was on the 5th day in 50% of the corneas, however, an expressive number of corneas suffered changes on the 6th, 7th and 8th day. Corneal graft preserved after 6 hours of death had a greater tendency to lower cell count and to decrease in evaluation grades.

摘要

目的

通过裂隙灯和电子显微镜检查分析角膜移植片的变化评估,以确保为患者提供高质量水平的供体角膜。

方法

对2002年9月至2003年2月间捐赠给索罗卡巴眼库的203只角膜进行前瞻性评估。根据以下因素将评估分为0至3级:暴露和上皮损伤、基质混浊、后弹力层皱褶、多形性、大小不均和角膜小滴、内皮蜗牛迹、水肿、反射率。将数据与死亡至保存的时间、内皮细胞计数和供体年龄相关联。

结果

对203只角膜进行了评估。供体的平均年龄为55岁(标准差=14.8岁)。死亡至保存的平均时间为9.1小时(最短2小时,最长25小时)。86只角膜的评估结果恶化,其中66.3%的角膜内皮细胞计数少于2500个,59.3%的角膜死亡至保存的时间超过6小时。分级变化的平均天数为第5天。

结论

年轻供体的角膜移植片评估明显优于老年供体。50%的角膜评估变化平均时间为第5天,然而,相当数量的角膜在第6、7和8天出现变化。死亡6小时后保存的角膜移植片更倾向于细胞计数降低和评估等级下降。

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