Silva Rafaella Nascimento E, Sampaio Lycia Maria Martins Pinho Pedral, Moriyama Aline Silveira, Pereira Nicolas Cesário, Lane Mark, Silva Hudson Vergennes da, Forseto Adriana Dos Santos
Hospital Oftalmológico de Sorocaba, Banco de Olhos de Sorocaba, Sorocaba, SP, Brazil.
University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.
Arq Bras Oftalmol. 2018 Apr;81(2):87-91. doi: 10.5935/0004-2749.20180021.
Donated corneas are classified as tectonic if there are defects within any layers of the cornea which would prevent a satisfactory visual outcome after transplantation. This study aimed to evaluate whether some tectonic corneas have sufficient endothelial characteristics to allow their use in posterior lamellar keratoplasty, and explored their reclassification for use in this sight-improving procedure.
A retrospective review of all corneal tissues preserved by the Sorocaba Eye Bank from January to April of 2014 was performed. All donated corneas classified as tectonic were included. Endothelial tissue was defined as healthy and viable for posterior lamellar keratoplasty if endothelial cell density was ≥2000 cells/mm2. Additional parameters analyzed included Descemet folds and stretch marks, loss of endothelial cells, corneal endothelial polymegathism/ pleomorphism, pseudo-guttata, and reflectivity.
During the study period, 2,847 corneas were preserved, of which 423 (14.85%) were classified as tectonic. Of these, 87 (20.56%) were reported as having endothelial viability and were included in the posterior lamellar keratoplasty group. Average corneal endothelial cell density of this group was 2,471 SD ± 256 cells/mm2 (range 2012-2967 cells/mm2).
A significant number of corneas classified as tectonic showed endothelial viability and were included in the posterior lamellar keratoplasty group (20.56%). Despite stromal and/or epithelial alterations, these corneas could have been potentially distributed for posterior lamellar transplantation to improve vision, thus reducing the corneal transplantation waiting period. This study highlights how corneal tissue reclassification could increase the potential amount of corneal tissue available for optical transplantation.
如果角膜的任何层存在缺陷，导致移植后无法获得满意的视觉效果，则捐赠的角膜被归类为结构性角膜。本研究旨在评估一些结构性角膜是否具有足够的内皮特征，以允许其用于后板层角膜移植，并探讨对其进行重新分类以用于这种改善视力的手术。
对索罗卡巴眼库2014年1月至4月保存的所有角膜组织进行回顾性研究。纳入所有分类为结构性的捐赠角膜。如果内皮细胞密度≥2000个细胞/mm²，则内皮组织被定义为健康且可用于后板层角膜移植。分析的其他参数包括后弹力层皱襞和伸展纹、内皮细胞丢失、角膜内皮大小不均/多形性、假性小滴和反射率。
在研究期间，共保存了2847只角膜，其中423只（14.85%）被分类为结构性角膜。其中，87只（20.56%）报告具有内皮活性，并被纳入后板层角膜移植组。该组角膜内皮细胞平均密度为2471 SD±256个细胞/mm²（范围2012 - 2967个细胞/mm²）。
相当数量分类为结构性的角膜显示出内皮活性，并被纳入后板层角膜移植组（20.56%）。尽管存在基质和/或上皮改变，但这些角膜本可潜在地分配用于后板层移植以改善视力，从而缩短角膜移植等待期。本研究强调了角膜组织重新分类如何能够增加可用于光学移植的角膜组织的潜在数量。
