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甘油保存角膜在角膜移植中的应用。

Use of glycerol-preserved corneas for corneal transplants.

作者信息

Gupta Neeti, Upadhyay Prerna

机构信息

Department of Ophthalmology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India.

出版信息

Indian J Ophthalmol. 2017 Jul;65(7):569-573. doi: 10.4103/ijo.IJO_56_17.

Abstract

PURPOSE

This study was carried out to see the results of glycerol-preserved cornea (GPC) in emergency situation when fresh corneal tissue was not available. The aim was to study the outcome of corneal transplantation using GPC.

METHODS

This was a retrospective study. The medical records of all the patients were reviewed, who underwent keratoplasty using "GPC" during the period from October 2011 to December 2015. The indication of keratoplasty, duration of preservation of the GPC, and its outcome were analyzed. Descriptive statistics were applied.

RESULTS

Out of the 222 penetrating keratoplasty (PKP) performed over the study period, the GPC was used in 34 patients (males = 31, 91.2%) aged 15-74 years. Therapeutic keratoplasty was performed in all cases in this cohort except one in which tectonic keratoplasty was done. The primary indication of PKP (91.2%) was infectious keratitis. Of these, 20 (64.5%) patients presented with perforated corneal ulcers. Post-PKP, ocular anatomy was preserved in 91.2%, and visual acuity of perception of light positive and accurate projection of rays in all the quadrants was obtained in 76.5% cases. Complications included glaucoma (n = 12, 35.1%), phthisis bulbi (n = 2, 5.9%), and graft reinfection and endophthalmitis after PKP (n = 1, 2.9%). The secondary procedure post-GPC and PKP were trabeculectomy with mitomycin C (n = 7, 58.3%) in patients not controlled on topical antiglaucoma medication. Optical keratoplasty was performed in (n = 3) 8.8% patients and triple procedure in (n = 2) 5.8% patients with good visual acuity postprocedure.

CONCLUSIONS

Acellular GPCs are useful in emergency keratoplasty to avoid loss of vision and can save the eye.

摘要

目的

本研究旨在观察在无法获得新鲜角膜组织的紧急情况下甘油保存角膜(GPC)的使用效果。目的是研究使用GPC进行角膜移植的结果。

方法

这是一项回顾性研究。回顾了2011年10月至2015年12月期间所有接受“GPC”角膜移植术患者的病历。分析了角膜移植的指征、GPC的保存时间及其结果。应用描述性统计。

结果

在研究期间进行的222例穿透性角膜移植术(PKP)中,34例患者(男性31例,占91.2%)年龄在15 - 74岁,使用了GPC。该队列中除1例行结构性角膜移植术外,所有病例均行治疗性角膜移植术。PKP的主要指征(91.2%)为感染性角膜炎。其中,20例(64.5%)患者出现角膜溃疡穿孔。PKP术后,91.2%的患者眼部解剖结构得以保留,76.5%的病例获得了光感阳性且各象限光线投射准确的视力。并发症包括青光眼(12例,35.1%)、眼球痨(2例,5.9%)以及PKP术后移植片再感染和眼内炎(1例,2.9%)。GPC和PKP术后的二次手术中,对于局部抗青光眼药物治疗效果不佳的患者,7例(58.3%)行丝裂霉素C小梁切除术。8.8%的患者(3例)行光学角膜移植术,5.8%的患者(2例)行三联手术,术后视力良好。

结论

脱细胞GPC在紧急角膜移植术中有助于避免视力丧失并挽救眼球。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1275/5549407/fdb1ad21d40e/IJO-65-569-g002.jpg

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