深低温冻存角膜影响因素的改良及在紧急角膜移植术中的应用价值  

The Improvement on Related Condition of Corneal Cryopreservation and Roles of Cryopreserved Corneas in Emergent Keratoplasty

作　　者：黄挺[1] 陈家祺[1] 陈龙山[1] 刘祖国[1] 林跃生[1] 冯春茂[1] 

机构地区：[1]中山医科大学中山眼科中心,广州510060

出　　处：《眼科学报》1999年第4期253-256,共4页Eye Science

摘　　要：目的:改良了影响深低温冻存效果的多项相关因素,探讨其对冻存的角膜内皮细胞活性的影响。应用于条件较差的病例行角膜移植术,评价其临床应用价值,尤其在紧急角膜移植术中的意义。方法:取术中钻取中央植片后残余的周边部角膜,行锥兰-茜素红染色,判定内皮细胞存活率;术后用角膜内皮反射显微镜检测角膜厚度及内皮细胞密度。观察术后植片上皮愈合及透明度变化,统计透明率、感染控制率、网脱复位率及视力恢复情况。结果:植片内皮细胞存活率82.1％,术后植片内皮密度1642个/mm^2,植片厚度0.59mm。非化学烧伤及热烧伤病例术后2～5天植片上皮愈合,2～4周植片透明。透明率87.5％,感染控制率90.63％,网脱复位率55.56％。感染控制及网膜复位病例视力均有不同程度提高。结论:改良的深低温冻存法有助于改善冻存的角膜内皮细胞活性,而且能随时提供角膜供体,在紧急角膜移植术中有特别重要意义。眼科学报1999;15:253-356。Purpose: To study the cryopreserved corneal endothelium viability on the condition that a series of related factors on long-term corneal cryopreservation were modified. The frozen corneas were used for emergent penetrating keratoplasty on poor condition patients. To evaluate the role of cryopreserved corneas on clinical application, especially on emergent keratoplasty. Methods: Residual peripheral corneas were stained with Trypan blue and Alizarin red in order to assess endothelium survival rate after central grafts were punched. Specular microscope was used to measure corneal thickness and count endothelium density. The transparent rate of grafts, infective control rate, retinal restorative rate and the recovery degree of visual acurity were emphasized respectively. Results: Endothelium survival rate of grafts was 82. 1% averagely. Postoperative endothelium density was 1 642cells/mm2 and graft thickness was 0. 59mm averagely. The epithelial defects healed after 2-5 days of the operation and edematous grafts were reclear after 2-4 weeks of the operation in all grafts, except for chemical bum and thermal burn. The transparent rate was 87. 5% . Infective contrail rate was 90. 63% . Retinal restorative rate was 55. 56%. Some useful visual acurity can be obtained when the infection was under controlled and the retinal was reattached. Conclusion: Modified long-term corneal cryopreservation is effective in maintaining endothelium viability and integrity. Furthermore, it could provide donors anytime because of it's unlimited preservative duration. Our study emphasizes especially the role of cryopreserved corneas in emergent keratoplasty. Eye Science 1999; 15: 253 - 256.

关 键 词：角膜低温保存 角膜移植 紧急手术 

分 类 号：R779.65[医药卫生—眼科] R318.52[医药卫生—临床医学]