Donor tissue preparation for Descemet membrane endothelial keratoplasty
Donor tissue preparation for Descemet membrane endothelial keratoplasty
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DOI：
10.1016/j.jcrs.2008.05.036
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发表时间：
2008-09-01
影响因子：
2.8
通讯作者：
Melles, Gerrit R. J.
中科院分区：
文献类型：
--
作者：
Lie, Jessica T.;Birbal, Renuka;Melles, Gerrit R. J.
目的：评估在后弹力层内皮角膜移植术 (DMEK) 中制备携带自体内皮的供体后弹力层的技术。地点：荷兰创新眼科手术研究所，鹿特丹，荷兰。方法：从经过器官培养 1 周的 10 个角巩膜边缘剥离携带自体内皮的直径 9.5 毫米的 DM。在剥离 DM 之前和之后以及另外 4 周的器官培养期间，用光学显微镜评估内皮细胞密度 (ECD)。结果：剥离 DM 之前和之后立即的平均 ECD 分别为 2701 个细胞/mm(2) +/- 302 (SD) 和 2719 +/- 322 个细胞/mm(2)，并从 1 周后的 2604 +/- 352 个细胞/mm(2) 下降到额外 4 周的器官培养后 (n = 10)，细胞数为 2190 +/- 768 个细胞/mm(2)。典型的“内皮条纹”，即在 DM 剥离后立即观察到的线性细胞破坏，在第二个培养期后显示出完全再生。结论：用于 DMEK 手术中移植的后弹力移植物可以通过手术从器官培养的角膜边缘制备出来，并在可接受的内皮细胞损失的情况下再保存 3 周。由于供体组织可以直接从器官培养的角巩膜边缘切下，因此大多数角膜外科医生可以轻松进行 DMEK 供体准备。
PURPOSE: To evaluate a technique for preparing a donor Descemet membrane carrying autologous endothelium for transplantation in Descemet membrane endothelial keratoplasty (DMEK).SETTING: Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands.METHODS: A 9.5 mm diameter DM carrying autologous endothelium was stripped from 10 corneoscleral rims that had been organ cultured for 1 week. The endothelial cell density (ECD) was evaluated with light microscopy before and immediately after DM was stripped and during 4 additional weeks of organ culture.RESULTS: The mean ECD was 2701 cells/mm(2) +/- 302 (SD) before and 2719 +/- 322 cells/mm(2) immediately after DM was stripped and declined from 2604 +/- 352 cells/mm(2) after 1 week to 2190 +/- 768 cells/mm(2) after an additional 4 weeks of organ culture (n = 10). Typical "endothelial streaks," ie, linear cellular disruptions observed immediately after DM was stripped, showed complete regeneration after the second culture period.CONCLUSIONS: Descemet grafts for transplantation in DMEK procedures can be surgically prepared from organ-cultured corneal rims and stored for an additional 3 weeks with acceptable endothelial cell loss. Because the donor tissue can be dissected directly from organ-cultured corneoscleral rims, donor preparation for DMEK can be readily accessible to most corneal surgeons.