Fatih Sultan Mehmet Research and Training Hospital, Ophthalmology Department, Istanbul, Turkey.
Beyoglu Research and Training Hospital, Ophtalmology Department, Istanbul, Turkey.
Semin Ophthalmol. 2022 Jan 2;37(1):3-6. doi: 10.1080/08820538.2021.1896754. Epub 2021 Apr 6.
To report the tectonic role of circular and square-shaped lamellar grafts without using extra corneas.
We retrospectively reviewed 23 lamellar patch grafts performed over a six-year period for various tectonic indications in corneal thinning and perforations. The anterior stroma of corneal endothelium peeled for Descemet Membrane Endothelial Keratoplasty were used to prepare circular lamellar corneal grafts. After punch trepanation of donor corneas for penetrating keratoplasty, the remaining rim of the cornea was used to prepare square-shaped grafts.
Circular lamellar grafts were used in 13 eyes that had paracentral or central corneal thinning or perforations. Square-shaped grafts were used in 10 eyes, nine of which had peripheral corneal thinning or perforations, and one, limbal. Anatomical success after tectonic grafts was achieved in 22 of 23 eyes (95.6%) at a mean follow-up of 9.83 ± 6.27 months. The mean of the best-corrected visual acuity improved from logMAR 2.29 ± 0.23 preoperatively to logMAR 1.35 ± 0.2 postoperatively, at the final follow-up.
The main disadvantage of patch grafts is the shortage in corneal supply due to insufficient cornea donation in developing countries like Turkey. By evaluating unused corneal rims, extra corneas will not be required.
报告不使用额外角膜的圆形和方形板层移植物的构建作用。
我们回顾性分析了 6 年来因各种角膜变薄和穿孔的构建适应证而进行的 23 例板层补丁移植。用于进行 Descemet 膜内皮角膜移植的角膜内皮前基质被用于制备圆形板层角膜移植物。穿透性角膜移植时，在供体角膜上进行冲孔后，剩余的角膜边缘被用于制备方形移植物。
13 只眼因中央或旁中央角膜变薄或穿孔而使用圆形板层移植物。10 只眼使用方形移植物，其中 9 只眼因周边角膜变薄或穿孔，1 只眼因角巩膜缘变薄而使用。23 只眼中的 22 只（95.6%）在平均 9.83±6.27 个月的随访中达到了解剖学上的成功。最佳矫正视力从术前 logMAR2.29±0.23 提高到术后 logMAR1.35±0.2，在最终随访时。
补丁移植物的主要缺点是由于像土耳其这样的发展中国家角膜供体不足导致角膜供应短缺。通过评估未使用的角膜边缘，不需要额外的角膜。
