不同方法获取Descemet膜-角膜内皮细胞复合体的效果比较  

Comparison of different harvesting technique for Descemet membrane-corneal endothelial cells complex

作　　者：叶向彧[1] 盛耀华[1] 周秀莉[1] 徐国庆[1] 

机构地区：[1]上海交通大学附属新华医院眼科,200092

出　　处：《眼科研究》2008年第9期645-648,共4页Chinese Ophthalmic Research

摘　　要：目的评价不同方法获取Descemet膜-角膜内皮细胞复合体(DM+CECs)的效果。方法将20只兔(40只眼)根据手术方法的不同随机分成4组:镊子剥离组、水分离组、大气泡法组和机械分离组,每组10只眼。通过活体染色和组织切片分析评价DM+CECs。结果成功获取DM+CECs镊子剥离组2眼,水分离组8眼,大气泡法组5眼,机械分离法组3眼,4个组之间的成功率差异有统计学意义(P<0.05)。水分离法组(98.03±2.18)%和大气泡法组(97.14±3.04)%内皮细胞存活率(ESR)明显高于镊子剥离法组(80.16±5.21)%和机械分离法组(71.56±9.57)%(F=436.04,P<0.05)。苏木精-伊红染色显示水分离法和大气泡法对内皮细胞损伤小。结论水分离法或大气泡法是安全、有效地获取DM+CECs的技术。Objective The possible restoration of the visual performance of corneal endothelial disorder may be obtained by selective transplantation of only Descemet lnembrane and endothelium,but preparation of the donor tissue is more challenging. Present paper was to evaluate the effect of different harvesting technique for Descemet membrane-corneal endothelial cells complex （ DM ＋ CECs）. Methods Forty eyes from 20 New Zealand white rabbits were randomly divided into four groups according to the surgical procedures：the stripping, hydrodissection, big-bubble and mechanical group and each group consisted of 10 eyes. The DM ＋ CECs were analyzed using vital staining for endothelium and standard histological preparation. Results Harvesting success were in 2 eyes for stripping group,8 eyes for hydrodissection group,5 eyes for big-bubble group and 3 eyes for mechanical group, showing a significant difference in success rate among four group （ P 〈 0.05 ）. The endothelial cells survival rate （ ESR ） of hydrodissection group（98.03 ± 2. 18% ） and big-bubble group（97. 14 ± 3.04% ） was significantly higher than that of stripping group（ 80. 16±5.21%）and mechanical group（71.56 ±9.57%）with a significant difference（F = 436.04,P 〈0.05）. The alizarin red/trypan blue staining showed that CECs remained the original morphology with slight damage in hydrodissection and big-bubble groups. Conclusion The hydrodissection and big-bubble technique appear to be safe and effective for harvesting DM ＋ CECs.

关 键 词：角膜 内皮细胞 角膜移植 Descemet膜-角膜内皮细胞复合体 

分 类 号：R779.65[医药卫生—眼科]