ABSTRACT
PURPOSE: Pre-Descemet's endothelial keratoplasty (PDEK) donor tissue preparation involves the intrastromal injection of air to create a type 1 big bubble (BB) and avoidance of the creation of a type 2 BB. The purpose of this study was to design and test a technique to consistently creates a type 1 BB without risk of creating a type 2 BB. METHODS: A prospective matched study with 64 human donor sclerocorneal discs, which were not suitable for corneal transplantation, was conducted. The corneas were divided into two groups, of which 32 were subjected to the standard technique of preparing the PDEK donor tissue (group 1, control) and 32 new technique, where in the donor Descemet's membrane was scored with a Sinskey hook. Frequency of occurrence of different types of BB was compared and statistically analysed. RESULTS: With the standard technique (group 1), type 1 BB occurred in 53.1%, type 2 BB in 34.4% and mixed BB in 12.5% of samples. With the scoring technique (group 2), a type 1 BB occurred in 100% of the samples. No type 2 or mixed BB occurred in any case in group 2. The difference in creation of a type 1BB between the two groups was statistically significant (p=0.00). CONCLUSION: The scoring technique is a simple, inexpensive and reproducible option to consistently achieve a type 1 BB to prepare PDEK graft tissue. The next step would be to study the clinical outcomes of PDEK performed with tissue obtained by the scoring technique.
Subject(s)
Corneal Diseases , Descemet Stripping Endothelial Keratoplasty , Cornea , Corneal Diseases/surgery , Descemet Membrane/surgery , Descemet Stripping Endothelial Keratoplasty/methods , Endothelium, Corneal , Humans , Prospective Studies , Tissue DonorsABSTRACT
Os linfócitos intraepiteliais (IELs) parecem desempenhar papel importante na defesa e na tolerância induzidas pelo tecido linfocitário associado à mucosa (MALT). No epitélio das mucosas, os IELs expressam a integrina HML-1, que é a responsável pela sua aderência no epitélio. Neste trabalho propöe-se estudar os mecanismos de expressäo do HML-1 nos linfócitos do sangue periférico associados ao epitélio corneal limbar. Culturas do epitélio da córnea de diferentes doadores e de linfócitos de sangue periférico de um paciente foram estabelecidas. Três grupos de estudo foram deteminados: Grupo A, linfócitos näo ativados juntamente com células epiteliais corneais limbares em meio de cultura; Grupo B, linfócitos näo-ativados separados do epitélio por membrana semi-permeável em meio de cultura; Grupo C, linfócitos näo-ativados em meio de cultura (controle). No sétimo dia, os linfócitos de todos os grupos ..