The results of successful penetrating keratoplasty using donor organ-cultured corneal tissue

被引:26
作者
Borderie, VM
Touzeau, O
Allouch, C
Scheer, S
Carvajal-Gonzalez, S
Laroche, L
机构
[1] Hop St Antoine, Serv Ophthalmol, Cornea Bank, F-77571 Paris 12, France
[2] Hop St Antoine, Dept Ophthalmol, F-77571 Paris, France
[3] Hop St Antoine, INSERM, U339, F-77571 Paris 12, France
关键词
D O I
10.1097/00007890-199906150-00007
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background. The aim of this study was identification of predictive factors for postoperative visual acuity in patients with a clear organ-cultured graft and to analyze the change in visual acuity between 12 and 24 months after transplantation. Methods. The study design was a prospective cohort study. A total of 342 consecutive penetrating keratoplasties using donor organ-cultured grafts, performed in 324 patients, were included. Visual acuity, graft thickness, and graft endothelial cell density were recorded in patients with clear transplants. Results. At 24 months postoperatively, 25 (18.7%) of 134 patients had 20/200 or worse visual acuity and 66 (49.3%) had 20/40 or better visual acuity, Graft thickness book 1 month to decrease to normal values. A temporary graft thinning occurred at 6 months postoperatively, followed by recovery of normal graft thickness by 18 months. The average postoperative endothelial cell density was 1,533+/-598 cells/mm(2) during the second year. The 24-month LogMAR (logarithm of minimal angle of resolution) visual acuity correlated with preoperative LogMAR visual acuity (beta=0.26, P=0.005), postoperative lens status (beta=-0.34, P=0.009), preoperative intraocular pressure (beta=0.50, P=0.020), and postoperative astigmatism (beta=0.17, P=0.040), Visual acuity (P=0.022) significantly improved between 1:1 and 24 months. Preoperative diagnosis (P < 0.0001) and postoperative lens status (P < 0.0001) significant:ly influenced the change in LogMAR visual acuity between 12 and 24 months. Conclusions. Donor variables do not influence the visual acuity results of penetrating keratoplasty using organ-cultured donor tissue, whereas they have a strong influence on graft survival and graft endothelial cell density. Visual acuity improves during the first 2 years after transplantation. After keratoplasty, organ-cultured corneal grafts undergo dramatic modifications of their thickness and probably of their transparency.
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收藏
页码:1433 / 1438
页数:6
相关论文
共 26 条
[1]   MORPHOLOGY, HISTOLOGY, AND ULTRASTRUCTURE OF HUMAN C31 ORGAN-CULTURED CORNEAS [J].
BORDERIE, VM ;
KANTELIP, BM ;
DELBOSC, BY ;
OPPERMANN, MT ;
LAROCHE, L .
CORNEA, 1995, 14 (03) :300-310
[2]  
Borderie VM, 1997, CORNEA, V16, P215
[3]   Donor organ cultured corneal tissue selection before penetrating keratoplasty [J].
Borderie, VM ;
Scheer, S ;
Touzeau, O ;
Vedie, F ;
Carvajal-Gonzalez, S ;
Laroche, L .
BRITISH JOURNAL OF OPHTHALMOLOGY, 1998, 82 (04) :382-388
[4]   Microbiologic study of organ-cultured donor corneas [J].
Borderie, VM ;
Laroche, L .
TRANSPLANTATION, 1998, 66 (01) :120-123
[5]   CORNEAL ENDOTHELIUM 5 YEARS AFTER TRANSPLANTATION [J].
BOURNE, WM ;
HODGE, DO ;
NELSON, LR .
AMERICAN JOURNAL OF OPHTHALMOLOGY, 1994, 118 (02) :185-196
[6]   Evaluation of corneal transplantation [J].
Coster, DJ .
BRITISH JOURNAL OF OPHTHALMOLOGY, 1997, 81 (08) :618-619
[7]   Survival analysis and visual outcome in a large series of corneal transplants in India [J].
Dandona, L ;
Naduvilath, TJ ;
Janarthanan, M ;
Ragu, K ;
Rao, GN .
BRITISH JOURNAL OF OPHTHALMOLOGY, 1997, 81 (09) :726-731
[8]   Long-term results of transsclerally sutured posterior chamber lenses in penetrating keratoplasty [J].
Djalilian, AR ;
Anderson, SO ;
Fang-Yen, M ;
Lane, SS ;
Holland, EJ .
CORNEA, 1998, 17 (04) :359-364
[9]  
EHLERS N, 1974, ACTA OPHTHALMOL, V52, P893
[10]  
EHLERS N, 1983, ACTA OPHTHALMOL, V61, P918