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[Emergency Keratoplasty with Porcine Xenografts in Necrotizing Keratitis].

作者信息

Drozhzhyna Galyna I, Gaidamaka Tetiana B, Cursiefen Claus, Bachmann Björn O, Ivanovska Olena V, Ostashevsky Viktor L, Kogan Boris M, Usov Volodymyr J, Pasyechnikova Natalija V

机构信息

Abteilung für Pathologie der Hornhaut, Staatsinstitut "Filatov Institut für Augenkrankheiten und Gewebetherapie der Nationalen Akademie der medizinischen Wissenschaften der Ukraine", Odessa, Ukraine.

Zentrum für Augenheilkunde, Universitätsklinikum Köln.

出版信息

Klin Monbl Augenheilkd. 2017 Nov;234(11):1387-1395. doi: 10.1055/s-0043-109694. Epub 2017 Jul 6.

Abstract

The great shortage of donor material in Ukraine makes it necessary to find additional sources of transplant material. A possible suitable material are the porcine corneas, as they are similar in structure and biomechanical parameters to the human cornea. The purpose of our study was to analyze the results of therapeutic keratoplasty (KP) with keratoxenotransplants from cryolyophilized porcine corneas in patients with severe necrotizing keratitis. A retrospective analysis of 32 xenotransplantations patients with severe necrotizing keratitis (17 lamellar, 6 stepped perforating, 4 perforating, 5 "biological coverage" according to Puchkovskaya) was completed. All eyes could be preserved, but the graft was rejected in all eyes. A semitransparent xenograft (XG) was achieved in 9 patients (33.3%). The best results were obtained after lamellar XKP with an XT diameter of 3.5 - 6.5 mm. Lamellar XTs with larger diameters (7.0 - 10.0 mm) were opaque. Postoperatively, the intensity of the inflammatory response after stepped XKP was slightly lower than that of the classical perforating XKP. A new KP with human corneas had to be performed in 5 patients, in one case combined with an antiglaucomatous operation and in another case with cataract extraction. Antiglaucomatous surgery had to be performed in 5 patients (15.6%). In the absence of human donor corneas, a porcine keratoxenoimplant can be used as temporary therapeutic keratoplasty in case of emergency stop the inflammation process and to save the eye. In cases of keratoxenoimplant, a poor visual outcome is expected.

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