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目的探讨角膜成功移植5a后内皮细胞丢失与供体年龄的关系。方法我们选择347例成功接受角膜移植的患者,移植术后5a患者出现角膜上皮营养不良和假性角膜水肿。显微镜下观察术前和术后6个月、12个月供体角膜,并在5a后测量角膜内皮细胞密度。结果移植术后5a所有患者的角膜内皮细胞密度比正常值均明显降低。接受12-65岁供体提供角膜移植的患者平均细胞丢失率为69%,内皮细胞密度平均为824mm-2(613-1342mm-2);而供体年龄为66-75岁时,患者平均细胞丢失率为75%,平均内皮细胞密度为654mm-2(538-986mm-2)2组比较差异有统计学意义(P=0.04)。结果表明供体年龄和内皮细胞密度有负相关关系(r=-0.19,95%可信区间-0.29-0.08)。结论角膜移植术后5a内皮细胞会大量丢失,而且细胞丢失率与供体年龄有负相关关系该研究提示要对角膜移植术后患者进行长期随访,观察细胞丢失率与供体年龄的关系是否会影响植片存活时间。
Objective To investigate the relationship between endothelial cell loss and donor age after successful corneal transplantation of 5a. METHODS We selected 347 patients who had undergone corneal transplantation successfully and had corneal epithelial malnutrition and pseudogenic corneal edema after 5a. The corneas were observed under the microscope before and 6 months and 12 months postoperatively, and the corneal endothelial cell density was measured after 5 years. Results The corneal endothelial cell density of all patients after 5 years of transplantation was significantly lower than the normal value. Patients who received corneal transplants from 12-65-year-olds had an average loss of 69% of cells and an average of 824mm-2 of endothelial cell density (613-1342mm-2), while those at donor ages 66-75 yielded a mean The loss rate was 75%, the average endothelial cell density was 654mm-2 (538-986mm-2), the difference between the two groups was statistically significant (P = 0.04). The results showed a negative correlation between donor age and endothelial cell density (r = -0.19, 95% confidence interval -0.29-0.08). Conclusions Corneal transplantation resulted in a large loss of endothelial cells after corneal transplantation and a negative correlation between cell loss rate and donor age. This study suggests that long-term follow-up of patients after corneal transplantation should be performed to observe whether the relationship between cell loss rate and donor age Affect graft survival time.