Residual corneal stroma in big-bubble deep anterior lamellar keratoplasty: a histological study in eye-bank corneas
Residual corneal stroma in big-bubble deep anterior lamellar keratoplasty: a histological study in eye-bank corneas
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DOI：
10.1136/bjophthalmol-2011-300360
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发表时间：
2011-10-01
影响因子：
4.1
通讯作者：
Brahma, Arun K.
中科院分区：
文献类型：
--
作者：
McKee, Hamish D.;Irion, Luciane C. D.;Brahma, Arun K.
目的探讨大气泡深前板层角膜移植(DALK)术后受者后板层是否残留角膜基质。将成功形成大泡的样本送往组织学评估，以确定是否有残留的基质残留在后弹力膜(DM)上。结果32例供体角膜均形成大泡。可以看到两种不同类型的大气泡：气泡边缘为白色(30个角膜)或边缘清晰(两个角膜)。所有白缘性角膜后板层均有残留基质，中央厚度2.6~17.4微米，平均7.0微米。结论不应再认为大气泡DALK有白色边缘的大气泡是DM的常规表现。DM的真正暴露可能只发生在不太常见的清晰边际泡沫的情况下。
Aim To determine if residual corneal stroma remains on the recipient posterior lamella in big-bubble deep anterior lamellar keratoplasty (DALK).Methods Pneumodissection using the big-bubble technique was carried out on eye-bank corneas mounted on an artificial anterior chamber. Samples that had a successful big-bubble formation were sent for histological evaluation to determine if any residual stroma remained on the Descemet membrane (DM).Results Big-bubble formation was achieved in 32 donor corneas. Two distinct types of big-bubble were seen: the bubble had either a white margin (30 corneas) or a clear margin (two corneas). The posterior lamellae of all the white margin corneas showed residual stroma on DM with a mean central thickness of 7.0 mu m (range 2.6-17.4 mu m). The clear margin corneas showed no residual stroma on DM.Conclusion It should no longer be assumed that big-bubble DALK, where the bubble has a white margin, routinely bares DM. True baring of DM may only occur with the less commonly seen clear margin bubble.