Krause A, Tost M, Schlaffer G
Klinik und Poliklinik für Augenkrankheiten, Martin-Luther-Universität Halle-Wittenberg.
Klin Monbl Augenheilkd. 1995 Mar;206(3):161-4. doi: 10.1055/s-2008-1035422.
Excessive cornea defects after chemical, thermal and microbiological damages respectively trophic disturbances often demand measures for conservation of the bulbus.
In the time between 1969 and 1993 22 patients were provided with a "Keratoplasty according to Putschkowskaja": circular cut at the recipient eye 0.15 mm deep, trepan diameter 8.5 to 13 mm, without lamellar preparation, covering with a donor cornea of normal thickness by silk single sutures.
In 19 eyes the primary aim, the conservation of the bulbus, could be achieved. The complete transplant was mostly rejected after several months, only in two patients it healed by vascularisation. In one patient an abscess arose between recipient--cornea and transplant, which made explantation necessary. The histological examination of the transplant showed a purulent inflammation, swelling of the parenchym, partly absence of keratocytes and endothel cells, and a defect in the Bowman membrane.
The "Keratoplasty according to Putschkowskaja" can be useful as "living contact lens" besides other surgical measures for treatment (primary conservation of the bulbus) of excessive cornea defects. It seems that the existence of Bowman and Descemet membrane in the transplant prevents the decomposition of the donor cornea for a rather long time. By then the cornea defect has often healed leaving scars.
化学、热和微生物损伤后出现的角膜缺损过大，分别伴有营养障碍，常常需要采取措施来保护眼球。
1969年至1993年间，22例患者接受了“普施科夫斯卡娅角膜移植术”：在受体眼进行环形切割，深度为0.15毫米，环钻直径8.5至13毫米，不做板层制备，用单根丝线缝合，覆盖正常厚度的供体角膜。
19只眼中实现了保护眼球的主要目标。完整的移植片大多在数月后被排斥，只有2例通过血管化愈合。1例患者在受体角膜与移植片之间出现脓肿，因此必须进行移植片切除。移植片的组织学检查显示为脓性炎症、实质肿胀、部分角膜细胞和内皮细胞缺失，以及Bowman膜缺损。
“普施科夫斯卡娅角膜移植术”除了作为治疗角膜缺损过大的其他手术措施（首要的是保护眼球）外，还可作为“活的隐形眼镜”发挥作用。移植片中Bowman膜和Descemet膜的存在似乎能在相当长的时间内防止供体角膜分解。到那时，角膜缺损常常已经愈合并留下瘢痕。
