Thanathanee Onsiri, Sripawadkul Wathanee, Anutarapongpan Orapin, Luanratanakorn Patanaree, Suwan-Apichon Olan
Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Cornea. 2016 Sep;35(9):1175-8. doi: 10.1097/ICO.0000000000000841.
To report the surgical outcomes and complications of therapeutic penetrating keratoplasty (TPK) using glycerol-preserved corneas in infectious keratitis.
This is a retrospective, noncomparative case series of patients with severe infectious keratitis who received TPK using glycerol-preserved corneas from 2004 to 2014 in the Department of Ophthalmology, Srinagarind Hospital, Khon Kaen University. The medical records were reviewed for baseline characteristics, visual outcomes, recurrence rate, wound integrity, secondary glaucoma, and donor cornea storage times.
Twenty-two eyes from 22 patients were included. Age ranged from 28 to 85 years and the donor cornea sizes ranged from 7.5 to 9.5 mm. The most common causative agents were fungi (16/22, 72.7%). Eleven patients (50.0%) developed secondary glaucoma and 7 patients (31.8%) had wound leakage. Recurrence of infection was observed in 15 patients (68.2%) and 9 patients (40.9%) received enucleation or evisceration. Thirteen globes (59.1%) were saved and the final visual acuites ranged from 1/60 to light perception. The storage times of donor corneas varied between 2 days and 62 months. The length of donor cornea storage did not affect the success rate of surgical outcome.
TPK using glycerol-preserved corneas has a high rate of secondary glaucoma and recurrence of infection with unsatisfactory visual results. These corneas may be used as temporary emergency transplants in infectious keratitis when fresh corneas are unavailable to meet demands.
报告在感染性角膜炎中使用甘油保存角膜进行治疗性穿透性角膜移植术（TPK）的手术结果及并发症。
这是一项回顾性、非对照病例系列研究，纳入了2004年至2014年在孔敬大学诗里拉医院眼科接受使用甘油保存角膜的TPK治疗的严重感染性角膜炎患者。回顾病历以获取基线特征、视力结果、复发率、伤口完整性、继发性青光眼及供体角膜保存时间等信息。
纳入22例患者的22只眼。年龄范围为28至85岁，供体角膜大小为7.5至9.5毫米。最常见的病原体为真菌（16/22，72.7%）。11例患者（50.0%）发生继发性青光眼，7例患者（31.8%）出现伤口渗漏。15例患者（68.2%）观察到感染复发，9例患者（40.9%）接受了眼球摘除或眼内容物剜除术。13只眼球（59.1%）得以保留，最终视力范围为1/60至光感。供体角膜保存时间在2天至62个月之间。供体角膜保存时间不影响手术结果的成功率。
使用甘油保存角膜的TPK继发性青光眼发生率高，感染复发率高，视力结果不理想。当无法获得新鲜角膜满足需求时，这些角膜可作为感染性角膜炎的临时紧急移植材料。
