Ragunathan Suganiah, Ivarsen Anders, Nielsen Kim, Hjortdal Jesper
Department of Ophthalmology, Aarhus University Hospital, Noerrebrogade 44, 8000, Århus, Denmark,
Cell Tissue Bank. 2014 Dec;15(4):573-8. doi: 10.1007/s10561-014-9429-x. Epub 2014 Feb 14.
To compare precut and surgeon-cut organ cultured donor corneas for DSAEK. A total of 119 consecutive eyes treated with DSAEK were retrospectically identified. 65 grafts were cut by the surgeon (Moria, ALTK System) prior to DSAEK and 54 grafts were precut by laboratory technicians from the Danish Eye Bank (Horizon single-use system). 1 year after surgery, tomographic images were obtained with the Pentacam HR. Endothelial cell density (ECD) and best-corrected visual acuity (BCVA) was determined. Graft thickness and graft asymmetry was evaluated in the centre and 1 mm from the edge of the graft in 6 semi-meridians. 1 year after surgery, the ECD loss was similar in the two groups, averaging 25.9 ± 14 % in surgeon-cut, and 22.9 ± 17 % in precut group (p = 0.33). Mean central graft thickness was 172 ± 6 μm in surgeon-cut grafts and 182 ± 6 μm in precut grafts (p = 0.30). BCVA was similar in surgeon-cut and precut corneas; being 0.25 ± 0.02 logMAR and 0.24 ± 0.02 logMAR, respectively (p = 0.59). The graft asymmetry index was 1.48 ± 0.02 for surgeon-cut and 1.44 ± 0.02 for precut grafts. There were no significant differences in complications rate in both groups. No correlations between BCVA and central graft thickness or graft asymmetry index in both groups were observed. Organ cultured precut donor corneas are comparable with surgeon-cut grafts with respect to ECD, graft thickness and asymmetry, and postoperative complication rate.
比较用于角膜后弹力层内皮移植术(DSAEK)的预切割和术者切割的器官培养供体角膜。回顾性纳入了总共119只接受DSAEK治疗的连续眼。65片移植物在DSAEK术前由术者(Moria,ALTK系统)切割,54片移植物由丹麦眼库的实验室技术人员预切割(Horizon一次性使用系统)。术后1年,使用Pentacam HR获取断层图像。测定内皮细胞密度(ECD)和最佳矫正视力(BCVA)。在6个半子午线方向评估移植物中心及距移植物边缘1mm处的移植物厚度和移植物不对称性。术后1年,两组的ECD损失相似,术者切割组平均为25.9±14%,预切割组为22.9±17%(p = 0.33)。术者切割移植物的平均中央移植物厚度为172±6μm,预切割移植物为182±6μm(p = 0.30)。术者切割和预切割角膜的BCVA相似,分别为0.25±0.02 logMAR和0.24±0.02 logMAR(p = 0.59)。术者切割移植物的移植物不对称指数为1.48±0.02,预切割移植物为1.44±0.02。两组并发症发生率无显著差异。两组均未观察到BCVA与中央移植物厚度或移植物不对称指数之间的相关性。在ECD、移植物厚度和不对称性以及术后并发症发生率方面,器官培养的预切割供体角膜与术者切割的移植物相当。