Partial lamellar keratoplasty for peripheral corneal disease using a graft from the glycerin-preserved corneoscleral rim
Partial lamellar keratoplasty for peripheral corneal disease using a graft from the glycerin-preserved corneoscleral rim
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DOI：
10.1007/s00417-014-2642-2
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发表时间：
2014-05
期刊：
影响因子：
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通讯作者：
Hua Gao;Xiuxian Wang;Jose J. Echegaray;Suxia Li;Ting Wang;W. Shi
中科院分区：
文献类型：
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作者：
Hua Gao;Xiuxian Wang;Jose J. Echegaray;Suxia Li;Ting Wang;W. Shi
目的探讨部分板层角膜移植术（partial laminate keratoplasty，LK）治疗周边角膜病（peripheral corneal disease，PCD）的可行性。将供体移植物的角膜巩膜缘（其中角膜纽扣已被冲压并用于穿透性角膜移植术）保存在甘油中并用于LK手术。使用7.5-8.0 mm的环钻标记中央角膜。根据病变大小进行切除，然后移植部分环形角巩膜移植物以修复周边角膜。视力，屈光性散光，并发症monitored.Results26例（28眼），其中15例Terrien的边缘变性，8与蚕蚀性溃疡，2韦格纳肉芽肿，1与周边角膜溃疡。平均随访15个月（范围：6-36个月）。术后6个月，裸眼视力平均提高3.17 Snellen视力表行（P= 0.010），最佳矫正视力平均提高0.85 Snellen视力表行（P= 0.045）。屈光性散光下降5.1 ± 8.6D（P= 0.003）。2例移植物溃疡（复发）患者通过第二次部分LK成功治疗。没有移植物排斥occurrence.ConclusionsPartial LK使用移植物从角巩膜缘似乎是有效的PCD患者的治疗。这种方法节省了供体移植物，这在供体组织稀缺的国家或地区很重要。
BackgroundTo evaluate the feasibility of partial lamellar keratoplasty (LK) for treatment of peripheral corneal disease (PCD) using a graft from the corneoscleral rim preserved in glycerin.MethodsPatients who underwent LK for PCD at Shandong Eye Hospital from January 2006 to December 2012 were included. Corneoscleral rims of donor grafts, out of which the corneal buttons had been punched and used for penetrating keratoplasty, were preserved in glycerin and used for LK procedures. A trephine of 7.5–8.0 mm was used to mark the central cornea. An excision was made according to the size of the lesions, after which a partial ring-shaped corneoscleral graft was transplanted to repair the peripheral cornea. Visual acuity, refractive astigmatism, and complications were monitored.ResultsThere were 26 patients (28 eyes), including 15 patients with Terrien’s marginal degeneration, eight with Mooren’s ulcer, two with Wegener’s granulomatosis, and one with peripheral corneal ulcer. The mean follow-up was 15 months (range, 6–36 months). Uncorrected visual acuity was improved by a mean of 3.17 Snellen chart lines (P= 0.010), and best spectacle-corrected visual acuity was improved by a mean of 0.85 Snellen chart lines (P= 0.045) at 6 months after surgery. The refractive astigmatism decreased by 5.1 ± 8.6 diopters (P= 0.003). Two patients suffering graft ulcers (recurrence) were successfully treated by a second partial LK. No graft rejection occurred.ConclusionsPartial LK using a graft from the corneoscleral rim appears to be effective in the treatment of patients with PCD. This approach saves the donor graft, which is important in the countries or regions with scarcity of donor tissue.