Boulter Tyler, Rayl Sarah, McEntire M Wade, Mifflin Mark
Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, WI.
Utah Lions Eye Bank, Murray, UT.
Cornea. 2019 Jun;38(6):761-763. doi: 10.1097/ICO.0000000000001920.
We report 2 successful cases of Descemet Membrane Endothelial Keratoplasty using transplanted tissues from donors with a history of radial keratotomy (RK).
Four corneas were obtained from 2 donors with a history of RK. After one successful laboratory practice preparation of Descemet Membrane Endothelial Keratoplasty (DMEK) for each patient, 2 additional donor tissues were prepared for DMEK using the established eye bank protocols.
Recipient 1 was a 69-year-old female patient who underwent DMEK 6 hours after eye bank preparation of the graft. The postoperative course was uneventful with a clear, attached graft noted at all postoperative visits. The endothelial cell count of the recipient at 7 months was 1953 cells/mm, and the best-corrected distance visual acuity at 1 year was 20/25 + 2. Recipient 2 was a 79-year-old male patient whose DMEK surgery was performed 18 hours after eye bank preparation of the graft. The postoperative course was notable for a re-bubble with air at postoperative day 4 for a peripheral 30% detachment of the donor tissue. No adverse events were noted, with a clear, attached graft at all postoperative visits. A recipient cell count at 6 months showed 2024 cells/mm, and the best-corrected distance visual acuity at 1 year was 20/20.
Two patients received successful DMEK grafts using tissues from donors with a history of RK. Careful eye bank screening and processing of RK donor tissues has thus far yielded similar outcomes in our recipient patients to what would be expected using tissues from donors without a history of RK.
我们报告了2例使用有放射状角膜切开术（RK）病史的供体移植组织进行Descemet膜内皮角膜移植术成功的病例。
从2例有RK病史的供体获取了4只角膜。在为每位患者成功进行一次实验室制备Descemet膜内皮角膜移植术（DMEK）后，按照既定的眼库方案又制备了2份供体组织用于DMEK。
受体1是一位69岁的女性患者，在眼库制备移植物6小时后接受了DMEK手术。术后过程顺利，所有术后随访时移植物均清晰且附着良好。受体在7个月时的内皮细胞计数为1953个细胞/mm²，1年时的最佳矫正远视力为20/25 + 2。受体2是一位79岁的男性患者，其DMEK手术在眼库制备移植物18小时后进行。术后第4天出现供体组织周边30%脱离伴空气再形成气泡，但无不良事件发生，所有术后随访时移植物均清晰且附着良好。6个月时受体细胞计数显示为2024个细胞/mm²，1年时的最佳矫正远视力为20/20。
2例患者使用有RK病史的供体组织接受了成功的DMEK移植。迄今为止，眼库对RK供体组织进行仔细筛查和处理，在我们的受体患者中产生的结果与使用无RK病史供体组织预期的结果相似。
