Wiffen S J, Nelson L R, Ali A F, Bourne W M
Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Cornea. 1995 Nov;14(6):554-61.
Our purpose was to evaluate the role of specular microscopy in the assessment of donor corneas for transplantation. We conducted retrospective analysis of specular microscopic evaluations of 1,000 consecutive donor corneas processed at Mayo Clinic Eye Bank from 1986 to 1993. Thirty-four of the 1,000 corneas were excluded from transplantation use on the basis of specular microscopic examination. Twenty-four corneas were excluded because of the presence of dark spots on the endothelium that did not clear with time. Large endothelial cells were found in six corneas on inspection, with a mean cell density of 1,160 cell/mm2 (795-1,597 cells/mm2). The remaining four excluded corneas showed evidence of endothelial trauma. Of 966 corneas not excluded, 520 (mean cell density 2,632 cells/mm2, range 1,621-4,590 cells/mm2) were transplanted at the Mayo Clinic, and the rest were distributed for transplantation elsewhere, when possible. Six of the corneas transplanted at the Mayo Clinic (1.2%) failed primarily. There ware no significant differences in the preoperative characteristics of the donor corneas between the donor failures and the clear grafts. Specular microscopic examination excluded 3.4% of donor corneas on the basis of unsatisfactory endothelium. Despite examination of the endothelium, six of 520 transplanted corneas (1.2%) suffered primary graft failure. Morphologic assessment of donor corneal endothelium by specular microscopy probably lessens, but does not eliminate, the risk of primary donor failure.
我们的目的是评估角膜内皮显微镜检查在供体角膜移植评估中的作用。我们对1986年至1993年在梅奥诊所眼库处理的1000例连续供体角膜的角膜内皮显微镜检查结果进行了回顾性分析。在这1000例角膜中，有34例因角膜内皮显微镜检查结果而被排除用于移植。24例角膜因内皮出现黑点且未随时间消退而被排除。检查发现6例角膜存在大内皮细胞，平均细胞密度为1160个细胞/mm²（795 - 1597个细胞/mm²）。其余4例被排除的角膜显示有内皮损伤迹象。在966例未被排除的角膜中，520例（平均细胞密度2632个细胞/mm²，范围1621 - 4590个细胞/mm²）在梅奥诊所进行了移植，其余的则在可能的情况下分配到其他地方进行移植。在梅奥诊所移植的角膜中有6例（1.2%）发生了原发性移植失败。原发性移植失败的供体角膜与移植成功的供体角膜在术前特征方面没有显著差异。角膜内皮显微镜检查基于内皮不满意排除了3.4%的供体角膜。尽管对内皮进行了检查，但520例移植角膜中有6例（1.2%）发生了原发性移植失败。通过角膜内皮显微镜检查对供体角膜内皮进行形态学评估可能会降低但不能消除原发性供体失败的风险。
