Department of Ophthalmology, Chang Gung Memorial Hospital at Keelung, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Cornea. 2012 Oct;31(10):1103-6. doi: 10.1097/ICO.0b013e31821c9ba2.
To report the surgical outcome of therapeutic penetrating keratoplasty (TPKP) using glycerol-preserved donor corneas in severe infective keratitis.
Glycerol-preserved corneas were obtained from the recipient corneas of the patients who underwent optical penetrating keratoplasty and preserved in glycerol. Eight eyes of 8 patients (3 men/5 women; average age, 69.7 years) with severe corneal ulcer with perforation were treated with TPKP using glycerol-preserved corneas.
With a mean follow-up time of 31.1 months (range, 9-58 months), satisfactory anatomical integrity was obtained in 7 patients (87.5%) at the end of the follow-up. Eradication of infection without recurrence was obtained in 7 eyes (87.5%). The mean reepithelialization time was 10.2 days. One patient (12.5%) received secondary optical penetrating keratoplasty. The pre-TPKP visual acuity ranged from no light perception to 0.06. After surgery, 4 eyes (50%) improved or maintained preoperative visual acuity and four eyes (50%) had no light perception but maintained anatomical integrity. One had a recurrent infection and needed antibiotics and amniotic membrane graft. One suffered from secondary glaucoma and received evisceration 19 months later.
Glycerol-preserved donor corneas may be effective substitutes in TPKP to control severe infective keratitis and preserve anatomical integrity.
报告使用甘油保存的供体角膜进行治疗性穿透性角膜移植术（TPKP）治疗严重感染性角膜炎的手术结果。
从接受光学穿透性角膜移植术的患者的受体角膜中获得甘油保存的角膜，并保存在甘油中。8 例 8 眼（3 男/5 女；平均年龄 69.7 岁）严重角膜溃疡伴穿孔患者接受了甘油保存角膜的 TPKP 治疗。
平均随访 31.1 个月（范围，9-58 个月），7 例（87.5%）患者在随访结束时获得了满意的解剖完整性。7 眼（87.5%）感染得到消除且无复发。平均上皮再植时间为 10.2 天。1 例（12.5%）患者接受了二次光学穿透性角膜移植术。TPKP 术前视力从无光感至 0.06。术后 4 眼（50%）改善或保持术前视力，4 眼（50%）无光感但保持解剖完整性。1 例发生复发性感染，需要使用抗生素和羊膜移植。1 例发生继发性青光眼，19 个月后行眼球摘除术。
甘油保存的供体角膜可能是 TPKP 治疗严重感染性角膜炎和保持解剖完整性的有效替代品。
