Kanavi Mozhgan Rezaei, Fahim Pejman, Rahmanian Mohsen, Chamani Tahereh, Kheiri Bahar, Balagholi Sahar, Javadi Mohammad Ali
Ocular Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Central Eye Bank of Iran, Tehran, Iran.
J Ophthalmic Vis Res. 2017 Oct-Dec;12(4):380-384. doi: 10.4103/jovr.jovr_179_16.
To describe the preparation and thickness profiles of endothelial keratoplasty lenticules harvested from eyes with previous photorefractive keratectomy (PRK).
Donor whole eyes that underwent PRK were subjected to microkeratome-assisted dissection for Descemet stripping automated endothelial keratoplasty. Specular microscopy and Visante optical coherence tomography were performed on precut corneas. Endothelial cell indices and thickness profiles of endothelial keratoplasty lenticules were statistically analyzed. Postoperative reports for transplanted lenticules were recorded.
Over a 6-month period, 2,929 whole eyes from 1,471 donors were screened for PRK. Twenty-five (0.85%) eyes from 14 donors were diagnosed with disciform haziness due to prior PRK and were used uneventfully for preparation of endothelial keratoplasty lenticules. Mean endothelial cell count was 3164.6 ± 311.0/mm and mean central posterior lenticule thickness was 128 ± 34 μm. Posterior lenticules revealed an increase in thickness from the central to peripheral cornea (mean increase of 26.2 μm at pericentral and 90.4 μm at peripheral locations). Mean increase in thickness was statistically different between two peripheral locations (74.5 μm vs. 108.1 μm, = 0.047). Postoperative reports of transplanted lenticules revealed no posterior flap detachment or loss of clarity at least three months after the surgery.
PRK donor whole eyes are potential sources for preparation of microkeratome-assisted thin endothelial keratoplasty lenticules with a high endothelial cell count. Although an asymmetric and significant increase in thickness was present at the peripheral cornea, neither attachment nor clarity of transplanted lenticules was affected by variations in thickness of precut corneas.
描述从曾接受过准分子激光原位角膜磨镶术（PRK）的眼睛中获取的内皮角膜移植透镜的制备方法及厚度分布情况。
对接受过PRK的供体全眼进行微型角膜刀辅助下的深板层内皮角膜移植术（DSAEK）剥离操作。对术前角膜进行角膜内皮显微镜检查和Visante光学相干断层扫描。对内皮角膜移植透镜的内皮细胞指数和厚度分布进行统计学分析。记录移植透镜的术后报告。
在6个月的时间里，对1471名供体的2929只全眼进行了PRK筛查。14名供体的25只眼（0.85%）因既往PRK出现盘状混浊，被顺利用于制备内皮角膜移植透镜。平均内皮细胞计数为3164.6±311.0/mm²，中央后透镜平均厚度为128±34μm。后透镜显示从角膜中央到周边厚度增加（中央周边平均增加26.2μm，周边部位平均增加90.4μm）。两个周边部位的平均厚度增加在统计学上有差异（74.5μm对108.1μm，P = 0.047）。移植透镜的术后报告显示，术后至少三个月没有后弹力层瓣脱离或透明度丧失的情况。
PRK供体全眼是制备微型角膜刀辅助下高内皮细胞计数的薄内皮角膜移植透镜的潜在来源。尽管周边角膜厚度存在不对称且显著增加，但预切角膜厚度的变化并未影响移植透镜的附着或透明度。
