A New Method of Harvesting Descemet Membrane-Endothelium Complex Approaching From the Suprachoroidal Space for Descemet Membrane Endothelial Keratoplasty: An Experimental Animal Study
A New Method of Harvesting Descemet Membrane-Endothelium Complex Approaching From the Suprachoroidal Space for Descemet Membrane Endothelial Keratoplasty: An Experimental Animal Study
复制标题
DOI：
10.1097/ico.0b013e3181c6b637
复制
发表时间：
2010-08
期刊：
影响因子：
2.8
通讯作者：
S. Chang;J. Jun;K. Hong
中科院分区：
文献类型：
--
作者：
S. Chang;J. Jun;K. Hong
目的：报道一种从脉络膜上腔切取后弹力膜-内皮复合体用于后弹力膜内皮角膜移植的新方法。材料和方法：对12只兔24只眼进行显微分析，对12只猫24只眼进行大体摄影分析。兔子和猫的眼球被沿着赤道360度圆周切开。在巩膜与从脉络膜上间隙向中央角膜方向靠近的结缔组织之间，以螺旋方式逐步进行手动分离。在从虹膜-内皮-虹膜复合体中完全分离基质后，从虹膜根部外侧将其从球体中切除。将合成载体(软性隐形眼镜)放置在冲床上，然后将切除的复合体带到载体上，使虹膜内皮侧向上。对于设计的移植物尺寸，进行了两步下冲。对收获的复合体进行活性染色处理，并通过光学显微镜下拍摄的照片和大体特写进行评估。用计算机软件计算内皮细胞损失率。结果：手术成功率89.6%(43/48)。光镜分析总结构细胞损失率为1.83±2.34，大体分析为4.68±1.68%。结论：经脉络膜上腔整块切取后弹力膜-内皮复合体的新方法，在切取过程中对内皮的损伤最小，且可通过注射器携带和通过。
Purpose: To report the study in rabbits of a new method of harvesting Descemet membrane-endothelium complex approaching from the suprachoroidal space for Descemet membrane endothelial keratoplasty. Materials and Methods: Twenty-four eyes of 12 rabbits were used for microscopic analysis, whereas 24 eyes of 12 cats were used for gross photographic analysis. The enucleated eyeballs of the rabbits and cats were incised 360 degrees circumferentially along the equator. Manual separation was performed between the sclera and the underlying connective tissue approaching from the suprachoroidal space in the direction of the central cornea step by step in spiral pattern. After complete separation of the stroma from the Descemet membrane-endothelium-iris complex, it was excised from the globe at the outside of the iris root. The synthetic carrier (soft contact lens) was laid down on the punch block, and then the excised complex was brought over the carrier with the endothelium-iris side upward. Two steps of down punch for the designed graft size were performed. The harvested complexes were processed for vital stains and were evaluated through photography taken under a light microscope and gross close-up. The endothelial cell loss rates were calculated by a computer software. Results: The overall harvest success rate was 89.6% (43 of 48). The overall structural cell loss rate was 1.83 ± 2.34 by microscopic analysis and 4.68% ± 1.68% by gross photographic analysis. Conclusion: The new method of en bloc harvesting Descemet membrane-endothelium complex approaching from the suprachoroidal space could provide minimal damage to the endothelium during harvesting, and it can be carried and passed through an injector.