Yuksel Erdem, Yuksel Nilay, Akata Fikret
Deparment of Ophthalmology, Faculty of Medicine, Gazi University, Ankara, Turkey.
Ophthalmology Clinic, Ataturk Training and Research Hospital, Ankara, Turkey.
Acta Ophthalmol. 2015 Nov;93(7):e573-7. doi: 10.1111/aos.12692. Epub 2015 Apr 27.
To compare the two different 'in situ' methods of corneal trephination technique under morgue condition (morgue trephination technique, MTT) and classic scleracorneal removal technique (SRT).
A total of 1179 cases were evaluated for cornea donation at Gazi University Faculty of Medicine mortuary between the years 2008 and 2013 and were included to the study. Suitable donor corneas were retrieved with in situ trephination technique under morgue condition (group 1, MTT) or with in situ classic SRT (group 2, SRT). The two different 'in situ' methods were compared in terms of donor corneal biological quality (endothelial cell count, ECC) and functional outcome (presence of infection and primary graft failure).
One hundred and fifty-two of 1179 cases were suitable for corneal donation. Two hundred and twenty-nine corneas of 152 cases were transplanted, 108 corneas were obtained with MTT and 121 corneas were obtained with SRT. Pretransplant and post-transplant ECCs were 2402.5 ± 115.6 and 2108.3 ± 108.23 (p = 0.065) in MTT, respectively, and 2512.7 ± 130.4 and 2235.4 ± 201.8 (p = 0.059) in SRT, respectively. The incidence of primary graft failure and infection was not statistically significantly different between two method [2.7% and 1.6% (p = 0.223), 0.9% and 0.8% (p = 0.115)].
The two different 'in situ' methods, MTT and SRT, were similar in terms of donor ECC, presence of infection and primary graft failure. Cornea excision performed through the technique described herein may increase the corneal donation rates as result of reduced disfigurement to donor body and offer important contributions during surgery with good anatomic adaptation of tissues.
比较在停尸房条件下两种不同的角膜环切原位技术（停尸房环切技术，MTT）和经典的巩膜角膜切除术（SRT）。
2008年至2013年间，在加齐大学医学院停尸房对1179例角膜捐献病例进行评估，并纳入本研究。合适的供体角膜通过停尸房条件下的原位环切技术获取（第1组，MTT）或通过原位经典SRT获取（第2组，SRT）。比较两种不同的“原位”方法在供体角膜生物学质量（内皮细胞计数，ECC）和功能结果（感染的存在和原发性移植失败）方面的差异。
1179例中有152例适合角膜捐献。152例中的229只角膜进行了移植，MTT获取了108只角膜，SRT获取了121只角膜。MTT组移植前和移植后的ECC分别为2402.5±115.6和2108.3±108.23（p = 0.065），SRT组分别为2512.7±130.4和2235.4±201.8（p = 0.059）。两种方法之间原发性移植失败和感染的发生率无统计学显著差异[2.7%和1.6%（p = 0.223），0.9%和0.8%（p = 0.115）]。
两种不同的“原位”方法，MTT和SRT，在供体ECC、感染的存在和原发性移植失败方面相似。通过本文所述技术进行的角膜切除可能会因减少供体身体的毁容而提高角膜捐献率，并在手术过程中因组织良好的解剖适应性而做出重要贡献。
