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采用猫角膜内皮的坦帕环钻术

The Tampa Trephine technique with cat corneal endothelium.

作者信息

Sanchez-Thorin J C, Rocha G, Bowyer B L, Balisky L, Duplessie M D, Stevens S X, Rowsey J J

机构信息

Department of Ophthalmology, University of South Florida College of Medicine, Tampa 33612-4799, USA.

出版信息

Cornea. 1997 Jan;16(1):79-87.

PMID:8985638
Abstract

The Tampa Trephine (Martin Marietta Speciality Components, Largo, FL, U.S.A.) penetrating keratoplasty technique uses a 7.0-mm corneal donor button with six rectangular 1 x 2-mm tabs of Bowman's layer, 75 microns in thickness, which are inserted into the recipient stroma beneath Bowman's layer. We evaluated the safety of the Tampa Trephine tissue-trephination method on the cat corneal endothelium combining vital staining and scanning electron microscopy, comparing it with the standard Weck trephination technique. The Tampa Trephine tissue trephination produces a donor button with a 6.7-mm diameter central area of normal endothelium. Localized peripheral areas of cellular loss, endothelial and Descemet's tears, endothelial detachment, and folding along the border of the trephination were observed with the Tampa Trephine method, all located in an area of < or = 150 microns, adjacent to the edge of the button. Standard trephination induced a localized peripheral area of endothelial damage < 50 microns in extension from the donor edge. A theoretic maximal 8.4% peripheral endothelial cell loss is induced with the Tampa Trephine trephination method, compared with a 2.8% loss with the standard procedure. The peripheral location of the alterations after the Tampa Trephine does not hinder the viability of the corneal endothelium, as it has been clinically observed.

摘要

坦帕环钻术(美国佛罗里达州拉戈市马丁·玛丽埃塔特种部件公司)穿透性角膜移植技术使用一个7.0毫米的角膜供体植片,带有六个1×2毫米的矩形鲍曼层小片,厚度为75微米,将其插入受体基质中鲍曼层下方。我们结合活体染色和扫描电子显微镜评估了坦帕环钻术组织环钻法对猫角膜内皮的安全性,并将其与标准的韦克环钻技术进行比较。坦帕环钻术组织环钻法产生的供体植片中央有一个直径6.7毫米的正常内皮区域。使用坦帕环钻术方法观察到细胞丢失、内皮和后弹力层撕裂、内皮脱离以及沿环钻边缘折叠的局部周边区域,所有这些都位于植片边缘相邻的小于或等于150微米的区域内。标准环钻术导致供体边缘向外延伸小于50微米的局部周边内皮损伤区域。坦帕环钻术环钻法理论上最大可导致8.4%的周边内皮细胞丢失,而标准手术为2.8%。如临床观察到的那样,坦帕环钻术后改变的周边位置并不妨碍角膜内皮的活力。

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