长期低温保存角膜方法的建立和临床应用  

Experimental and clinical investigation of long term corneal cryopreservation

作　　者：蓝平[1] 高明宏[1] 孟彤柏[1] 范忠义[1] 姜彩辉[1] 李宝储[1] 

机构地区：[1]沈阳军区总医院眼科,110015

出　　处：《中国实用眼科杂志》2001年第2期135-138,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的 :探索简易安全的长期保存供体角膜方法 ,为临床提供优质角膜材料。方法 :建立简易深低温冻贮技术保存活性角膜材料和全眼球冷冻法、4℃甘油脱水法保存板层角膜移植材料。采用透射电镜和临床角膜移植术后随访观察对 3种方法保存的角膜材料进行了评价。结果 :电镜检查所见 :深低温保存的角膜片 ,内皮细胞完整 ,仅见线粒体肿大。在维持支架完整方面 ,深低温冻法效果最佳 ,全眼球冷冻法优于 4℃甘油脱水法。板层角膜移植术后 1～ 6年随访 ,全眼球冷冻法保存的植片 ( n=40 )透明率为6 7.5 % ,新生血管化为 32 .5 % ;4℃甘油脱水法 ( n=110 )透明率 6 1.8% ,新生血管化 37.3%。穿透性角膜移植和眼前节重建术后 1～ 3年随访情况分别为 ,深低温保存的植片增视率 75 .4%、 75 % ;透明率 75 .4%、 75 % ;角膜厚度 ( mm) 0 .5 4± 0 .0 5、 0 .6 1± 0 .0 6 ;内皮细胞密度 (细胞 / mm2 ) 1,0 35± 2 45 ,949± 312。结论 :简易深低温长期保存的角膜材料可用于穿透性角膜移植术。全眼球冷冻法可代替 4℃甘油脱水法长期保存板层角膜移植材料 。Purpose:To investigate simple and safe methods of long term corneal preservation for clinical use Methods:The simple corneal cryopreservation method,eyeball cryopreservation method and 4℃ preservation method in glycerol were established.These three methods were evaluated by the electron microscope and clinical follow up investgation.Results:Electron microscope examination revealed that the endothelial cells of simple cryopreseved corneas were intact with the swollen mitochodrion.For the corneal frames,the simple cryopreservation method had best result.The eyeball cryopreservation method was better than 4℃ preservation in glycerol.1 6years follow up of lamellar keratoplasty revealed that the transparency rates in eyeball cryopreservation method and 4℃ preservation in glycerol were respectively 69.7%,61 8% with the neovascularization rates 32.5%,37.3%respectively.1 3years follow up of the penetrating keratoplasty and the ocular anterior segment reestablishment revealed that the vision increase rates in two surgeries were respectively 84.1%and 75.4%,the transparency rates 75.4%and 75%,the coreal thickness(mm)0.54±0.05 and 0.61±0.06,the endothelial cell density(cells/mm 2)1035±245 and 949±312.Conclusion:The simple cryopreservation method is suitable for penetrating keratoplasty.The eyeball cyopreservation method may substitute the 4℃ preservation in glycerol for lamellar keratoplasty.

关 键 词：低温保存 角膜移植 供体 

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