Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD 21287, USA.
Cornea. 2011 Dec;30(12):1387-91. doi: 10.1097/ICO.0b013e31821c9c09.
To report the short-term outcome of gamma-irradiated sterile cornea in corneal and glaucoma patch graft surgeries when viable endothelium is not necessary.
Surgeons who have used the irradiated corneas were asked to rate their impression from 1 (fair) to 4 (very good). Specific intraoperative questions included availability, ease of use, clarity, thickness, tensile strength, and suturing. Postoperative outcomes included epithelialization, biological incorporation, and clarity of tissue, as well as any adverse outcomes.
Irradiated sterile cornea has been used in more than 150 surgeries so far. The major uses for irradiated cornea were as glaucoma patch graft (65.3%), as corneal patch graft (14%), in anterior lamellar keratoplasty (10.7%), and in keratoprosthesis (10%). The mean score for packaging of tissue was 3.75 (SD, 0.45), ease of use 3.83 (SD, 0.39), clarity 3.62 (SD, 0.51), thickness 3.67 (SD, 0.49), tensile strength 3.64 (SD, 0.50), and suturing 3.62 (SD, 0.65). Postoperative outcomes were also favorable, including epithelialization (mean ± SD, 3.46 ± 0.69), biological incorporation (mean ± SD, 3.46 ± 0.69), and clarity (mean ± SD, 3.43 ± 0.85). There were 4 episodes of corneal melt (all occurred in patients with previous corneal melt). There were no reported cases of tissue rejection or infection.
Gamma-irradiated sterile cornea is a promising new development that may help increase the supply of donor cornea tissue. It virtually eliminates the risk of infection while providing a long shelf life. It is particularly helpful in emergency situations or in remote areas. However, longer follow-up and a prospective study comparing the outcomes of the irradiated corneas with those of the optisol-stored corneas are needed.
报告在不需要有活力的内皮细胞时，用于角膜和青光眼补丁移植手术的伽马辐照无菌角膜的短期结果。
询问使用过辐照角膜的外科医生对其印象进行评分，分值为 1（一般）至 4（非常好）。具体的术中问题包括可用性、易用性、清晰度、厚度、拉伸强度和缝合。术后结果包括上皮化、生物整合和组织清晰度以及任何不良结果。
迄今为止，已在 150 多次手术中使用辐照无菌角膜。辐照角膜的主要用途是作为青光眼补丁移植物（65.3%）、角膜补丁移植物（14%）、前板层角膜移植术（10.7%）和角膜假体（10%）。组织包装的平均评分为 3.75（SD，0.45），易用性评分为 3.83（SD，0.39），清晰度评分为 3.62（SD，0.51），厚度评分为 3.67（SD，0.49），拉伸强度评分为 3.64（SD，0.50），缝合评分为 3.62（SD，0.65）。术后结果也很有利，包括上皮化（平均值±标准差，3.46±0.69）、生物整合（平均值±标准差，3.46±0.69）和清晰度（平均值±标准差，3.43±0.85）。有 4 例发生角膜融解（均发生在有先前角膜融解的患者中）。没有报告组织排斥或感染的病例。
伽马辐照无菌角膜是一种有前途的新发展，可能有助于增加供体角膜组织的供应。它几乎消除了感染的风险，同时提供了较长的保质期。它在紧急情况下或在偏远地区特别有帮助。然而，需要进行更长时间的随访和前瞻性研究，比较辐照角膜的结果与 Optisol 储存角膜的结果。
