Comparison of Graft Outcomes Reusing Original Intermediate-Term Cold Storage Solution for Entire Corneal Donor Storage Period With Exchanged Fresh Storage Solution After Donor Preparation in the Cornea Preservation Time Study.
Comparison of Graft Outcomes Reusing Original Intermediate-Term Cold Storage Solution for Entire Corneal Donor Storage Period With Exchanged Fresh Storage Solution After Donor Preparation in the Cornea Preservation Time Study.
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DOI：
10.1097/ico.0000000000003108
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发表时间：
2022-12-01
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影响因子：
2.8
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中科院分区：
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补充数字内容可在文本中获得。本研究的目的是评估Descemet剥离自动内皮角膜移植术的结果，在角膜保存时间研究中，比较在晶状体制备后使用新鲜的中期冷藏溶液与重复使用原始溶液的结果。在角膜保存时间研究中，508例供体角膜采用新鲜溶液交换眼库制备的晶状体（fresh组），283例采用原溶液重复使用（original组）。所有供体保存时间均≤11天。比较两组移植成功率、3年中心内皮细胞损失和供体边缘培养阳性的频率。Fresh组3年移植成功率（95%可信区间）为93.4% (90.7% ~ 95.3%)，Original组为95.2%(91.8% ~ 97.2%)（移植失败校正风险比= 0.64,95%可信区间，0.33 ~ 1.24,P = 0.19）。Fresh组内皮细胞损失的平均百分比明显高于Original组（分别为45%±22%和38%±20%，P = 0.004）。Fresh组267个供体轮辋（真菌3个，细菌1个）中4个（1.5%）培养阳性，Original组158个（2.5%）培养阳性（P = 0.57）。Original组术后感染2例，Fresh组无感染。在Descemet剥离自动内皮角膜移植术中，使用原始的中期冷藏溶液与使用新鲜溶液相比，3年移植成功率没有降低，而供体边缘培养阳性的频率在两组之间没有显著差异。
Supplemental Digital Content is Available in the Text. The purpose of this study was to evaluate outcomes of Descemet stripping automated endothelial keratoplasty comparing exchange with fresh intermediate-term cold storage solution after lenticule preparation versus reuse of the original solution in the Cornea Preservation Time Study. In the Cornea Preservation Time Study, 508 donor corneas had lenticules prepared by the eye bank with fresh solution exchange (Fresh group) and 283 with reuse of the original solution (Original group). Storage time for all donors was ≤11 days. Graft success rates, central endothelial cell loss at 3 years, and frequency of positive donor rim cultures were compared between the 2 groups. The 3-year graft success rate (95% confidence interval) was 93.4% (90.7%–95.3%) in the Fresh group and 95.2% (91.8%–97.2%) in the Original group (adjusted hazard ratio for graft failure = 0.64, 95% confidence interval, 0.33–1.24, P = 0.19). The mean percentage endothelial cell loss was significantly greater in the Fresh group versus Original group (45% ± 22% vs. 38% ± 20%, respectively, P = 0.004). Cultures were positive in 4 (1.5%) of 267 donor rims (3 fungal and 1 bacterial) in the Fresh group and in 4 (2.5%) of 158 in the Original group (P = 0.57). There were 2 postoperative infections in the Original group and none in the Fresh group. The use of the original intermediate-term cold storage solution did not reduce the 3-year graft success rate compared with exchanging with fresh solution after lenticule preparation for Descemet stripping automated endothelial keratoplasty, while the frequency of positive donor rim cultures did not significantly differ between groups.