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储存时间会影响角膜移植术的效果以减少角膜供体短缺吗?一项回顾性研究。

Does Storage Time Affect the Outcomes of Split Corneal Transplantation to Reduce Corneal Donor Shortage? A Retrospective Study.

作者信息

Kandemir Baran, Tutaş Günaydın Nesrin, Göktaş Eren, Tanyıldız Burak

机构信息

Department of Ophthalmology, University of Health Sciences Dr. Lutfi Kırdar Kartal City Hospital, Istanbul, Turkey.

Department of Ophthalmology, Sinop Boyabat 75. Year State Hospital, Sinop, Turkey.

出版信息

Inquiry. 2021 Jan-Dec;58:469580211045846. doi: 10.1177/00469580211045846.

Abstract

Split cornea transplantation can reduce the shortage of donor corneas. Therefore, this study aimed to evaluate the effect of split graft storage time on the outcomes of split corneal transplantation through Descemet membrane endothelial keratoplasty (DMEK) and deep anterior lamellar keratoplasty (DALK) surgeries. Split corneal transplantation was performed in 80 eyes using 41 donor corneas. The mean before and after splitting storage times and total storage times were recorded. Donor corneal buttons and split grafts were stored in short-term solution at 4°C. In both surgeries (DMEK and DALK), donor corneas were divided into groups depending on their storage times. Mean postoperative 12th month best corrected visual acuity (BCVA), endothelial cell density (ECD), endothelial cell loss (ECL), central corneal thickness (CCT), refractive spherical equivalent (RSE), refractive astigmatism, and complication rates were compared among the groups. Correlation between storage times and 1-year BCVA, ECL, and complication rates were assessed. Clinical outcomes of the groups 1 year after the surgeries were also compared. DALK and DMEK were performed in 41 and 39 eyes, respectively. Storage times were not correlated with 1-year DMEK outcomes and only weakly correlated with post-DALK ECD, ECL, and RSE values. Except for CCT in those that underwent DALK, the outcomes of DMEK and DALK surgeries with stored and non-stored split grafts were not significantly different ( = .02). The storage times of donor corneas and split grafts do not have any impact on outcomes.

摘要

角膜劈裂移植可以减少供体角膜的短缺。因此,本研究旨在通过Descemet膜内皮角膜移植术(DMEK)和深板层角膜移植术(DALK)评估劈裂移植物保存时间对角膜劈裂移植手术效果的影响。使用41个供体角膜对80只眼进行了角膜劈裂移植。记录了劈裂前后的平均保存时间和总保存时间。供体角膜植片和劈裂移植物保存在4℃的短期溶液中。在这两种手术(DMEK和DALK)中,供体角膜根据其保存时间分组。比较了术后第12个月各组的最佳矫正视力(BCVA)、内皮细胞密度(ECD)、内皮细胞丢失(ECL)、中央角膜厚度(CCT)、等效球镜度(RSE)、散光以及并发症发生率。评估了保存时间与1年BCVA、ECL和并发症发生率之间的相关性。还比较了手术后1年各组的临床结果。分别对41只眼和39只眼进行了DALK和DMEK手术。保存时间与1年DMEK手术结果无关,仅与DALK术后的ECD、ECL和RSE值弱相关。除了接受DALK手术者的CCT外,使用保存和未保存的劈裂移植物进行DMEK和DALK手术的结果无显著差异(P = 0.02)。供体角膜和劈裂移植物的保存时间对手术结果没有任何影响。

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