Posterior lamellar keratoplasty.
Posterior lamellar keratoplasty.
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后板层角膜移植术。
DOI：
10.1097/00003226-199403000-00011
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发表时间：
2002
影响因子：
--
通讯作者：
G. Melles
中科院分区：
文献类型：
--
作者：
G. Melles
穿透性角膜移植是目前治疗角膜内皮功能障碍的唯一方法。尽管角膜移植的成功率很高，但仍然存在一些问题，如供体移植物的可用性有限，穿透性角膜移植后屈光度的变化，以及免疫排斥反应的机率较高等。本研究以美国加州欧文CHIRON眼科公司的涂层水凝胶透镜为载体，将培养的同种猫和兔角膜内皮细胞移植到成年猫和兔体内。两个物种的移植程序是相同的。将同种异体兔或猫的角膜内皮细胞接种到涂层水凝胶透镜上，培养至单层，平均细胞密度为2500个/mm2。移植前5周取角膜内皮细胞，造成角膜水肿。然后细胞载体装置被移植如下：在基质中切一个环钻(7.7 mm)，产生一个外部角膜塞子。然后用5.5毫米的环钻切割内角膜，并丢弃这个内塞子。植入物被插入，外层角膜塞被缝合回原位。兔和猫的角膜在3天内完全透明，兔的平均透明时间为40天，猫的平均为50天。组织病理学评估显示，猫移植的角膜后有血管化的膜形成，而兔的角膜后膜无形成，基质细胞大量渗出，新生血管形成。
Penetrating keratoplasty is currently the only treatment for corneal endothelial dysfunction. Although corneal transplantation has a high success rate, a few problems still remain, such as the limited availability of donor grafts, the change in refraction after penetrating keratoplasty, and the higher chance of immune rejection. In this study, a coated hydrogel lens (Chiron Ophthalmics Inc., Irvine CA, USA) has been used as a carrier to transplant cultured homologous kitten and rabbit corneal endothelial cells into adult cats and rabbits. The transplantation procedure was the same in both species. Corneal endothelial cells from homologous rabbits or cats were seeded on coated hydrogel lenses and cultured until they reached a complete monolayer with an average cell density of 2,500 cells/mm2. Five weeks before transplantation surgery, corneal endothelial cells were scraped to induce corneal edema. The cell carrier device was then transplanted as follows: a trephine cut (7.7 mm) was made into the stroma, producing an outer corneal plug. The inner cornea was then cut by using a 5.5-mm trephine, and this inner plug was discarded. The implant was inserted and the outer corneal plug was sutured back into place. Corneas cleared completely within 3 days in both rabbits and cats, and stayed clear for an average of 40 days in rabbits and 50 days in cats. The histopathological evaluation of the rejected grafts showed vascularized retrocorneal membrane formation in cats, whereas in rabbits severe cellular infiltration of the stroma with neovascularization occurred without retrocorneal membrane formation.