Hong Jing, Liu Guang-Feng, Xia Ning, Gu Shao-Feng, Han Jing-Yi, Chai Li-Jing
The Eye Center, Third Hospital, Peking University, Beijing 100083, China.
Zhonghua Yan Ke Za Zhi. 2008 Feb;44(2):122-7.
To investigate the surgical procedure, clinical efficacy, complications, density of endothelial cells and histological changes after Descemet's stripping endothelial keratoplasty (DSEK) surgery.
It was a experimental study. Twenty four New Zealand rabbits were divided into 3 groups, 8 rabbits per group. Donor grafts were dissected from 16 New Zealand rabbit eyes. Group A was experimental group, a 5 mm limbal tunnel incision was made. Descemet's membrane was striped off at 10 mm diameter, then the same diameter donor cornea (including Descemet's membrane and endothelium with a little of posterior stroma) was inserted into the recipient's anterior chamber. Air was injected into the anterior chamber to press the graft up against the recipient cornea. Group B was the control group, only striped the Descemet's membrane at the recipient cornea. Group C was the experiment control group, the procedure was similar to the group A, but the donor graft was without endothelial cells.
All corneas of group A were transparent, and the mean density of the endothelial cells was (2195 +/- 77)/mm2 (t = 12.455, P < 0.001). Endothelial grafts attached to the recipients well and no scar formation between them under histological observation. The corneas were severe edema in groups B and C one month after surgery.
DSEK is a safe surgery, can be recovered rapidly with little damages, and without interface scar formation after surgery. DSEK may be the first choice for the treatment of bullous keratopathy.
探讨深板层内皮角膜移植术(DSEK)的手术操作、临床疗效、并发症、内皮细胞密度及组织学变化。
本研究为实验性研究。将24只新西兰兔分为3组,每组8只。从16只新西兰兔眼中获取供体植片。A组为实验组,制作5mm的角膜缘隧道切口。在直径10mm处剥离后弹力层,然后将相同直径的供体角膜(包括后弹力层和内皮细胞及少量后基质)植入受体前房。向前房内注入空气将植片压贴于受体角膜上。B组为对照组,仅在受体角膜上剥离后弹力层。C组为实验对照组,手术操作与A组相似,但供体植片无内皮细胞。
A组所有角膜均透明,内皮细胞平均密度为(2195±77)/mm²(t = 12.455,P < 0.001)。组织学观察显示内皮植片与受体贴附良好,二者之间无瘢痕形成。B组和C组术后1个月角膜出现严重水肿。
DSEK是一种安全的手术,损伤小,恢复快,术后无界面瘢痕形成。DSEK可能是大泡性角膜病变治疗的首选方法。