A Surgical Cryoprobe for Targeted Transcorneal Freezing and Endothelial Cell Removal.
A Surgical Cryoprobe for Targeted Transcorneal Freezing and Endothelial Cell Removal.
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DOI：
10.1155/2017/5614089
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发表时间：
2017
影响因子：
1.9
通讯作者：
Quantock AJ
中科院分区：
文献类型：
--
作者：
Akhbanbetova A;Nakano S;Littlechild SL;Young RD;Zvirgzdina M;Fullwood NJ;Weston I;Weston P;Kinoshita S;Okumura N;Koizumi N;Quantock AJ
目的：研究一种用于角膜内皮手术的新型冷冻探针经角膜冷冻的效果。 采用一氧化二氮作为冷冻剂的冷冻控制台用于冷却一系列不同的冷冻探针尖端设计，所述冷冻探针尖端设计由高导热性的银制成。对426只猪角膜进行体外研究，然后对3只兔角膜进行初步体内研究。 正如预期，经角膜冷冻破坏了角膜上皮;然而，上皮基底膜保持完整。使用具有凹形尖端轮廓的3.4 mm直径冷冻探针最佳地实现了可再现的内皮损伤。冷冻损伤后24小时，在前后弹力层区域观察到基质水肿，但冷冻后10天已消退。冷冻后1个月，可见正常的胶原纤维结构，同时伴有内皮细胞再生。 经角膜冷冻诱导短暂的后基质水肿和一些残留的深基质混浊，但保持上皮基底膜完整，这可能对角膜再上皮化很重要。局部破坏的内皮细胞单层，实现了一致的方式与3.4毫米直径/凹轮廓冷冻探针，并代表了一个潜在的有用的方法，以消除功能障碍的角膜内皮细胞从角膜内皮功能障碍。
To examine the effects of transcorneal freezing using a new cryoprobe designed for corneal endothelial surgery. A freezing console employing nitrous oxide as a cryogen was used to cool a series of different cryoprobe tip designs made of silver for high thermal conductivity. In vitro studies were conducted on 426 porcine corneas, followed by preliminary in vivo investigations on three rabbit corneas. The corneal epithelium was destroyed by transcorneal freezing, as expected; however, the epithelial basement membrane remained intact. Reproducible endothelial damage was optimally achieved using a 3.4 mm diameter cryoprobe with a concave tip profile. Stromal edema was seen in the pre-Descemet's area 24 hrs postfreeze injury, but this had been resolved by 10 days postfreeze. A normal collagen fibril structure was seen 1 month postfreeze, concurrent with endothelial cell repopulation. Transcorneal freezing induces transient posterior stromal edema and some residual deep stromal haze but leaves the epithelial basement membrane intact, which is likely to be important for corneal re-epithelialization. Localized destruction of the endothelial monolayer was achieved in a consistent manner with a 3.4 mm diameter/concave profile cryoprobe and represents a potentially useful approach to remove dysfunctional corneal endothelial cells from corneas with endothelial dysfunction.