Hudde T, Reinhard T, Möller M, Schelle C, Spelsberg H, Cepin A, Sundmacher R
Augenklinik der Heinrich-Heine-Universität, Düsseldorf.
Ophthalmologe. 1997 Nov;94(11):780-4. doi: 10.1007/s003470050203.
Donor corneas are normally obtained by whole globe enucleation-a procedure often refused by the bereaved. To increase the acceptance of cornea donation, we have exclusively obtained donor corneas by in situ excision since the end of 1994. There have been reports of increased endothelial damage and higher contamination rates. We report our experience in 1995 and 1996.
The in situ excision was performed by staff trained in microsurgical techniques. Only donor corneas with negative end-storage cultures after at least 10 days and an endothelial cell count of more than 2500 cells/mm2 were used for transplantation.
In all, 705 corneoscleral buttons were excised from 1/95 to 12/96. The bereaved consented in 34% in 1996. A total of 30.5% of the corneas were ineligible for transplantation which corresponds to the discard figures from all cornea banks with culture methods. We did not observe any primary transplant failure nor endophthalmitis after 444 perforating keratoplasties.
In situ corneal excision is safe, and helps to reduce the shortage in donor corneas.
供体角膜通常通过全眼球摘除术获取——这一 procedure 往往遭到逝者家属拒绝。为提高角膜捐献的接受度,自1994年底起,我们专门通过原位切除术获取供体角膜。有报道称内皮损伤增加且污染率更高。我们报告1995年和1996年的经验。
原位切除术由接受过显微外科技术培训的工作人员进行。仅将至少10天后终末储存培养阴性且内皮细胞计数超过2500个细胞/mm²的供体角膜用于移植。
1995年1月至1996年12月共切除705个角膜巩膜钮。1996年逝者家属同意率为34%。共有30.5%的角膜不符合移植条件,这与采用培养方法的所有角膜库的废弃率相当。444例穿透性角膜移植术后未观察到任何原发性移植失败或眼内炎。
原位角膜切除术安全,有助于减少供体角膜短缺。