Objective To evaluate changes in endothelial cell density， visual acuity and refractive outcomes after deep anterior lamellar keratoplasty （DALK） using glycerin-cryopreserved corneal tissue. Methods This was a retrospective case-control study. The clinical data were collected from 44 patients （49 eyes） who had been diagnosed with keratoconus who had undergone DALK with glycerin-cryopreserved corneal tissue at Shandong Eye Institute and Hospital. Among them， 17 patients （17 eyes） were followed up at 1 month， 1 year， 2 years， 3 years， and 4 years. Endothelial cell loss， visual acuity， and refractive status of these 17 eyes were recorded. Data were analyzed using a paired t test. Results The mean follow-up period was 39.0±12.6 months and no graft rejection occurred. The mean endothelial cell density （ECD） was 2597±578 cells/mm2 before surgery， and was 1790±409 cells/mm2， 1703±443 cells/mm2， 1632±389 cells/mm2， 1638±357 cells/mm2， 1675±283 cells/mm2 and 1611±421 cells/mm2 at 1 month， 1 year， 2 years， 3 years， and 4 years postoperatively. Cell density was reduced by 34.2% at 4 years postoperatively compared with the density before surgery. The mean uncorrected visual acuity （UCVA） was 1.40±0.60 logMAR， and best-corrected visual acuity （BCVA） was 0.98±0.54 logMAR. Mean BCVAs at 1 month， 1 year， 2 years， 3 years and 4 years postoperatively were 0.44±0.12 logMAR， 0.36±0.20 logMAR， 0.32±0.23 logMAR， 0.29±0.20 logMAR and 0.27±0.16 logMAR. Conclusion Glycerin-cryopreserved corneal tissue can be safe and effective for deep anterior lamellar keratoplasty to treat keratoconus and provides higher survival rates of the corneal endothelium.
Patel SV， Hodge DO， Bourne WM. Corneal endothelium and postoperative outcomes 15 years after penetrating keratoplasty. Am J Ophthalmol，2005，139：311-319.
[2]
Muraine M， Toubeau D， Gueudry J， et al. Impact of new lamellar techniques of keratoplasty on eye bank activity. Graefes Arch Clin Exp Ophthalmol，2007，245：32-38.
[3]
Armitage WJ， Easty DL. Factors influencing the suitability of organ-cultured corneas for transplantation. Invest Ophthalmol Vis Sci，1997，38：16-24.
[4]
Shimazaki J， Shimmura S， Ishioka M， et al. Randomized clinical trial of deep lamellar keratoplasty vs penetrating keratoplasty. Am J Ophthalmol，2002，134：159-165.
[5]
Chen W， Lin Y， Zhang X， et al. Comparison of fresh corneal tissue versus glycerin-cryopreserved corneal tissue in deep anterior lamellar keratoplasty. Invest Ophthalmol Vis Sci，2010， 51：775-781.
[6]
Fontana L， Parente G， Tassinari G. Clinical outcomes after deep anterior lamellar keratoplasty using the big-bubble technique in patients with keratoconus. Am J Ophthalmol，2007，143：117-124.
[7]
Bahar I， Kaiserman I， Srinivasan S，et al. Comparison of three different techniques of corneal transplantation for keratoconus. Am J Ophthalmol，2008，146：905-912.
[8]
Kawashima M， Kawakita T， Den S， et al. Comparison of deep lamellar keratoplasty and penetrating keratoplasty for lattice and macular corneal dystrophies. Am J Ophthalmol，2006，142：304-309.
[9]
Myung H， Tae C， Eui C. A retrospective contralateral study comparing deep anterior lamellar keratoplasty with penetrating keratoplasty. Cornea，2012，31：1-5.
[10]
Borderie VM， Bo?觕lle PY， Touzeau O， et al. Predicted long term outcome of corneal transplantation. Ophthalmology，2009， 116：2354-2360.
[11]
Roberta F， Luciene B. Deep anterior lamellar transplant using lyophilized and optisol corneas in patients with keratoconus. Cornea，2008，27：1030-1036.
[12]
Chau GK， Dilly SA， Sheard CE， et al. Deep lamellar keratoplasty on air with lyophilised tissue. Br J Ophthalmol，1992，76：646-650.
[13]
Sugita J， Kondo J. Deep lamellar keratoplasty with complete removal of pathological stroma for vision improvement. Br J Ophthalmol，1997，81：184-188.
[14]
Watson SL， Ramsey A， Dart JK， et al. Comparison of deep lamellar keratoplasty and penetrating keratoplasty in patients with keratoconus. Ophthalmology，2004，111：1676-1682.
[15]
Coombes AG， Kirwan JF， Rostron CK. Deep lamellar keratoplasty with lyophilised tissue in the management of keratoconus. Br J Ophthalmol，2001，85 ：788-791.
浙公网安备 33030202001892号