深低温保存对穿透性角膜移植术后植片厚度和内皮细胞的影响  

Postoperative thickness and the endothelial cells of the cryopreserved graft applied in penetrating keratoplasty

作　　者：高明宏[1] 蓝平[1] 孟彤柏[1] 曲静涛[1] 夏国英[1] 

机构地区：[1]沈阳军区总医院眼科,110016

出　　处：《中国实用眼科杂志》2002年第12期938-940,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的 :探讨深低温保存对穿透性角膜移植术后植片厚度和内皮细胞的影响。方法 :采用SP -2 0 0 0非接触式角膜内皮显微镜 (Topcon ,日本 )和角膜内皮分析仪 ,对 2 6眼冷冻植片的术后植片厚度和内皮细胞变化进行了临床动态观察 ,并以 3 2眼新鲜植片做对照。结果 :术后 1个月 ,冷冻植片组的植片厚度显著大于新鲜植片组 (P <0 0 1) ;术后 3、 6和 12个月 ,两组差异无显著性 (P >0 0 5 )。术后 1、 3、 6和 12个月 ,冷冻植片组内皮细胞密度均显著低于新鲜植片组 (P <0 0 5 )。术后 1和 3个月 ,冷冻植片组内皮细胞丢失率、细胞面积变异系数和六角形细胞比率均与新鲜植片组有显著差异 (P <0 0 1,P <0 0 5 ) ;术后 6和 12个月 ,两组差异无显著性 (P >0 0 5 )。结论 :深低温冷冻保存的角膜存在一定潜在损伤 ,移植术后内皮细胞丢失率和形态学改变比新鲜植片显著 ;植片水肿恢复速度较慢。但术后 1年仍然具有维持角膜透明的内皮细胞密度、正常的细胞形态和正常的角膜厚度。Objective:To investigate the influence of cryopreservation on the thickness and the endothelial cells of the grafts which was used in penetrating keratoplasty. Methods:The thickness and endothelial cells of 26 cryopreserved grafts and 32 fresh grafts were measured by SP-2000 non-contacted specular microscope. Results:The thickness of the cryopreserved grafts was significantly higher than that of the fresh grafts at one month after operation (P<0 01).But there were no differences between two groups at 3,6 and 12 months after operation (P>0 05).The densities of the endothelial cells of the cryopreserved grafts were lower those that of the fresh ones at 1,3,6 and 12 months after operation (P<0 05).There were significant differences in the loss rate of endothelial cells,the cell variant coefficient and the hexagonal cell rate between the two groups (P<0 05) at 1 and 3 months after operation,but no differences at 6 and 12 months after operation (P>0 05). Conclusions:The latent freeze-thaw injury results in longer corneal edema,the enough endothelial cells density,however,may maintain the transparency of the cryopreserved grafts.

关 键 词：角膜内皮显微镜 穿透性角膜移植 低温保存 

分 类 号：R779.65[医药卫生—眼科]