| 目的 观察将无活性内皮细胞的保存角膜用于穿透性移植对角膜穿孔的治疗效果。方法：-20度保存无活性内皮细胞的全层角膜做为穿透性移植供体角膜，在受体做特殊的深层桥状植床，尽量多的保存自体后弹力层和内皮，常规间断或连续缝合，观察植片存活状况、视力、排斥反应和并发症等情况。结果：5例患者早期植片均透明、视力不同程度提高，1例患者晚期发生排斥反应，经局部使用免疫抑制剂控制。结论：在利用新的深层桥式穿透性移植手术最大限度保存自体角膜内皮的前提下，无活性内皮细胞保存角膜可望用于常规角膜穿孔治疗，相应的动物试验正在进行中。
关键词：角膜穿孔 内皮细胞 穿透性 角膜移植
Primary clinic application of deep- lamella bridge-type Penetrating Keratoplasty with no activity endothelial for Treatment of Corneal Perforation
Abstract Objective To observe the effect of deep- lamella bridge-type Penetrating Keratoplasty with no activity endothelial for treatment of Corneal Perforation. Methods Full layers of corneas with no activity endothelial cell preserved at –20o C were used as donor corneas.Receptors were designed as a special deep- lamella bridge-type to preserve autograft’Descemet membrane and endothelial cells . Receptors were fixed with interrupted or continuous suture. The grafts 、vision and complications were observed after operation. Results Early grafts remained transparent and vision was improved in 5 cases. Late graft rejection was found in 1 case and immunosuppressive agents were used successfully to control it . Conclusions With a new deep- lamella bridge-type Penetrating Keratoplasty to preserve endothelial cells of autograft, preserved corneas with no activity endothelial cells may used for Treatment of Corneal Perforation .Animal tests are in progress.
Key words corneal perforation endothelial cell penetrating keratoplasty |
