Fenzl Carlton R, Gess Adam J, Moshirfar Majid
John A Moran Eye Center, University of Utah, Salt Lake City, UT, USA.
Eye Doctors of Washington, Washington, DC, USA.
Clin Ophthalmol. 2014 Nov 27;8:2391-6. doi: 10.2147/OPTH.S73591. eCollection 2014.
The Moria single-use adjustable depth trephine is a device that allows a goal trephination depth to be set prior to the surgical procedure.
Eleven fresh human cadaveric eyes were trephined using 8.0 mm Moria single-use adjustable vacuum trephines. Prior to trephination, the average corneal pachymetry in the peripheral 7-10 mm range was obtained using anterior segment optical coherence tomography. The trephination depth was set to 80% of that value. Light microscopy was used to image anteroposterior cross-sections of each corneal specimen. Digital protractor software was used to evaluate the trephination angle, depth, and length. All adequately processed specimens were included in the analysis. In addition, trephination angle data from a previous publication by Moshirfar et al were used as a comparison with those of this study.
Trephination analysis of depth compared with pachymetry revealed a mean of 83.7%±6.53% (95% confidence interval 79.8-87.6). Maximum and minimum trephined depths were 95.35% and 71.3%, respectively. Trephination depth compared with angular corneal thickness yielded a mean of 66.2%±4.79% (95% confidence interval 63.0-69.4). Maximum and minimum depths were 73.7% and 59.7%, respectively. Analysis of trephination angle yielded a mean of 130.2±3.57 degrees (95% confidence interval 127.8-132.61). Maximum and minimum angles were 135.5 degrees and 126 degrees, respectively. The standard deviation of the trephination angle of the Moria trephine was found to be significantly less than that of Hessburg-Barron and Hanna trephines calculated in the previous study.
The Moria adjustable vacuum trephine is an accurate method of trephination when a specific depth is desired. Further investigation is needed to determine the relevance of this in relation to deep anterior lamellar keratoplasty.
Moria一次性可调深度环钻是一种可在手术前设定目标环钻深度的设备。
使用8.0毫米的Moria一次性可调真空环钻对11只新鲜人尸体眼进行环钻。在环钻之前，使用眼前节光学相干断层扫描获得周边7 - 10毫米范围内的平均角膜厚度。将环钻深度设定为该值的80%。使用光学显微镜对每个角膜标本的前后横截面进行成像。使用数字量角器软件评估环钻角度、深度和长度。所有处理得当的标本都纳入分析。此外，将Moshirfar等人之前发表的一篇文章中的环钻角度数据用作本研究数据的对比。
与角膜厚度测量相比，环钻深度分析显示平均值为83.7%±6.53%（95%置信区间79.8 - 87.6）。最大和最小环钻深度分别为95.35%和71.3%。与角膜角厚度相比，环钻深度平均值为66.2%±4.79%（95%置信区间63.0 - 69.4）。最大和最小深度分别为73.7%和59.7%。环钻角度分析得出平均值为130.2±3.57度（95%置信区间127.8 - 132.61）。最大和最小角度分别为135.5度和126度。发现Moria环钻的环钻角度标准差显著小于先前研究中计算的Hessburg - Barron和Hanna环钻的标准差。
当需要特定深度时，Moria可调真空环钻是一种准确的环钻方法。需要进一步研究以确定其与深前板层角膜移植术的相关性。
