Honda Norihiko, Mimura Tatsuya, Usui Tomohiko, Amano Shiro
Department of Ophthalmology, University of Tokyo School of Medicine, Tokyo, Japan.
Arch Ophthalmol. 2009 Oct;127(10):1321-6. doi: 10.1001/archophthalmol.2009.253.
To investigate the feasibility of Descemet stripping automated endothelial keratoplasty (DSAEK) using cultured human corneal endothelial cells (HCECs) in an animal model.
Descemet stripping automated endothelial keratoplasty grafts were produced by seeding cultured HCEC suspensions onto human corneal stromal discs. Three insertion techniques were assessed in an ex vivo model. The feasibility of DSAEK grafts with cultured HCECs was examined in a rabbit model. Rabbits received stromal disc transplants with cultured HCECs (c-DSAEK) or without HCECs (controls).
The HCECs on the DSAEK grafts had a consistent size and polygonal shape. Mean (SD) percentage of cell loss in the taco-folding group (38.7% [5.2%]) was significantly greater than that in the Busin glide (11.6% [1.5%]; P = .001) and lens glide (18.0% [5.4%]; P = .007) groups. Corneal transparency gradually recovered in the c-DSAEK group, whereas edema persisted for up to 28 days in controls. Histologic examination after surgery revealed donor HCECs covering the posterior surface of the graft in the c-DSAEK group.
Further enhancements of the efficacy and safety of DSAEK using cultured HCECs will make this a clinically feasible alternative therapy for corneal endothelial dysfunction.
Descemet stripping automated endothelial keratoplasty using cultured HCECs may be a novel therapeutic approach to treat corneal endothelial dysfunction.
在动物模型中研究使用培养的人角膜内皮细胞（HCECs）进行后弹力层剥除自动内皮角膜移植术（DSAEK）的可行性。
通过将培养的HCEC悬液接种到人角膜基质盘上制作DSAEK移植物。在体外模型中评估了三种植入技术。在兔模型中检验了含培养HCECs的DSAEK移植物的可行性。兔子接受含培养HCECs的基质盘移植（c-DSAEK）或不含HCECs的基质盘移植（对照组）。
DSAEK移植物上的HCECs大小一致且呈多边形。墨西哥卷饼式折叠组的细胞损失平均（标准差）百分比（38.7% [5.2%]）显著高于布辛滑动法组（11.6% [1.5%]；P = 0.001）和晶状体滑动法组（18.0% [5.4%]；P = 0.007）。c-DSAEK组角膜透明度逐渐恢复，而对照组水肿持续长达28天。术后组织学检查显示c-DSAEK组供体HCECs覆盖在移植物后表面。
进一步提高使用培养HCECs的DSAEK的疗效和安全性将使其成为角膜内皮功能障碍临床上可行的替代治疗方法。
使用培养HCECs的后弹力层剥除自动内皮角膜移植术可能是治疗角膜内皮功能障碍的一种新的治疗方法。
