内皮,角膜

摘要： 目的 观察玻璃体切除术后共焦显微镜下前房残留重水对角膜的影响.方法 回顾性研究.深圳市眼科医院2008年9月至2018年12月玻璃体切除手术后前房残留重水共26例(26眼),采用激光角膜共焦显微镜检查,分析其角膜形态结构特征.结果 共焦显微镜下前房残留重水压迫的角膜内皮细胞呈"金箔样"改变.重水渗入角膜内皮边界使其六边形结构轮廓平直清晰.严重者重水进入角膜基质.角膜的内皮细胞被大量色素颗粒覆盖.结论 采用激光角膜共焦显微镜可观察前房残留重水对角膜内皮细胞产生直接或间接的损伤.

摘要： 目的 观察不同年龄段老年性白内障患者超声乳化术前后角膜内皮细胞的变化.方法 将不同年龄段老年性白内障患者120例120眼分为三组,Ⅰ组年龄60 ～＜ 70岁,40例40眼,Ⅱ组年龄70 ～＜ 80岁,40例40眼,Ⅲ组年龄≥80岁,40例40眼,行超声乳化联合人工晶体植入术,术前及术后1、3、6个月测量角膜中央区内皮细胞密度,进行统计学分析比较.结果 三组超声乳化术时间及术中累积释放能量比较差异无统计学意义(P＞0.05);三组术后各随访期角膜内皮细胞密度均小于术前,差异有统计学意义(P＜0.05),各组随访期同时点角膜内皮细胞密度比较差异无统计学意义(P＞0.05);三组随访期各时点角膜内皮细胞丢失率比较差异无统计学意义(P＞0.05);三组患者手术均顺利,未出现后囊膜破裂、玻璃体溢出等并发症.术后部分患者有不同程度的角膜水肿,均在一周内恢复透明.结论 不同年龄段老年性白内障患者行白内障超声乳化手术,对角膜内皮细胞的影响无明显差异.

摘要： 目的 探讨Fuchs角膜内皮营养不良(FECD)的影像学特征,为该病的诊断提供影像学依据.方法 回顾性系列病例研究.收集北京同仁眼科中心门诊2014年1月至2016年12月临床诊断为FECD的患者64例(128只眼),其中男性19例,女性45例,年龄(57.8±12.9)岁.FECD I期25只眼(19.5％)、11期81只眼(63.3％)、Ⅲ期16只眼(12.5％)、IV期6只眼(4.7％).所有患者均行角膜内皮显微镜检查,41例(82只眼)同时行角膜共聚焦显微镜(IVCM)检查.分析患者一般资料,患眼FECD分期、角膜内皮显微镜及IVCM检查结果.计数资料进行卡方检验,计量资料进行方差分析,无法准确测量的资料进行秩和检验.结果 随着疾病进展,所有患眼在角膜内皮显微镜下均可见暗区数量、出现率、融合率均出现上升,IVCM小滴状结构的数量增多,小滴有成对、成串融合发展至成片融合.I ～IV期FECD患眼的角膜内皮暗区数量的秩均次分别为78.2、228.4、284.5、288.5,各期间差异有统计学意义(X2=84.183,P=0.000).I期所有患眼角膜各部位均未见暗区融合,II期(45.1％,146/324)、Ⅲ期(76.3％,45/59)、IV期(83.3％,15/18)周边角膜内皮暗区融合的出现率逐渐升高(x2=27.167,P=0.000).结论 角膜内皮显微镜及IVCM影像特征可以作为早期FECD诊断的重要依据.角膜内皮显微镜可快速筛查FECD,IVCM可通过分析角膜小滴状结构影像融合特征指导疾病分期.

摘要： Objective To investigate the clinical outcomes of Pre-descement membrane endothelial keratoplasty (PDEK) for treatment of patients with corneal endothelial decompensation.Methods Retrospective study of case series.The cases of 20 patients (20 eyes) who were diagnosed with corneal endothelial decompensation induced by various original diseases and received PDEK during July 2016 and December 2016 at Zhongshan Ophthalmic Center have been analyzed.The participants included 8 males and 12 females with an average age of(59.3±11.8)years.All 20 patients received PDEK operation,the Dua's layer,descement membrane and endothelium of donor tissue were separated from the underlying stroma with the application of big-bubble technique,and donor discs with diameters of 7.75 or 8.00 mm were harvested with scissors.The donor discs were stained with 0.06％ trypan blue and loaded on inserters which were then gently inserted into the anterior chamber of the recipient.When the rolled inserted graft was unfolded,air was carefully injected into the anterior chamber underneath the graft so that the graft can attach to the stroma of the recipient.Post-operation follow-ups of over 6 months have been conducted for all patients,the best spectacle corrected visual acuity (BSCVA),the position of donor disc,corneal thickness and corneal endothelial cell density (ECD) were documented.The pre-operation and post-operation (6 months postoperatively) corneal thickness data of the patients were analyzed with paired sample t test.Results The success rate of preparing PDMEK donor disc with big-bubble technique is 90％ (18/20).Eighteen patients (90％) received PDMEK surgery successfully.Anterior segment optical coherence tomography (AS-OCT) results indicated that sixteen donor discs (16/18) were well attached to the back surface of the recipient stroma,and that two discs (2/18) dislocated at 6 days after surgery.At 6 months post-operatively,the corneas of 14 patients (14/18) turned clear with their BSCVA ranging 0.4 to 1.0,and the ECD was (1 389.3 ±373.2) cells/mm2 for the patients with clear corneas.At 6 months post-operatively,the average corneal thickness of the patients reduced to (605 ±45) μm from the preoperative level of (655± 56) μm,and the differences are of statistical significance (t=2.137,P=0.032).Conclusions Application of big-bubble technique could effectively secure the success rate of PDEK disc preparation and control the loss of donated corneas.PDEK disc can be easily handled and unrolled in the anterior chamber,which could improve the postoperative clinical outcomes.%目的 探讨角膜后弹力层前内皮移植术(PDEK)治疗角膜内皮功能失代偿的特点.方法 回顾性病例系列研究.收集2016年7至12月在中山大学中山眼科中心就诊的角膜内皮功能失代偿患者20例,其中男性8例,女性12例,平均年龄(59.3±11.8)岁.对所有患者行PDEK,采用大气泡技术分离Dua层、后弹力层和内皮层,制作直径为7.75或8.00 mm的PDEK植片,经0.06％锥兰染色后植入患者前房,展平并注入空气固定植片.术后随访6个月,观察视力、内皮植片位置、角膜厚度和内皮细胞密度.对术前和术后6个月的角膜厚度进行配对t检验.结果 采用大气泡技术制作PDEK植片的成功率为90％(18/20).PDEK手术成功率为90％(18/20).术后16例(16/18)患者眼前节相干光层析成像术检查结果显示角膜内皮植片贴附平整,仅2例(2/18)患者出现内皮植片脱离.术后6个月时,14例(14/18)患者角膜透明,最佳矫正视力为0.4～1.0.角膜内皮细胞密度为(1 389.3±373.2)个/mm2.术后6个月时中央部角膜厚度为(605±45) μm,与术前(655±56)μm比较差异有统计学意义(t=2.137,P=0.032).结论 PDEK植片制作成功率高,可以减少供体浪费.PDEK植片较容易展平和固定,提高了手术成功率.

摘要： 角膜内皮移植术是一种选择性置换病变的角膜内皮,同时保留正常的角膜上皮和基质层的手术,目前已逐渐取代穿透性角膜移植术而被广泛用于治疗角膜内皮功能失代偿.角膜内皮移植术后内皮细胞丢失数量明显少于穿透性角膜移植术.角膜内皮细胞数量和功能是维持角膜透明及提示植片存活的重要因素,因此术后内皮细胞密度的变化对预测预后具有重要意义.本文在总结角膜内皮移植术的基础上,详细阐述术后内皮细胞密度的变化及其影响因素,以期为临床诊疗工作提供参考和依据.%Endothelial keratoplasty is a surgery that selectively replaces the diseased endothelium and reserves the normal corneal epithelial and stromal layers. It is now gradually replacing penetrating keratoplasty in treating endothelial dysfunction. Although endothelial cell loss exists after endothelial keratoplasty, the number of lost cells is obviously less than that of penetrating keratoplasty. The amount and function of corneal endothelial cells are important factors for maintaining corneal transparency and indicating the survival of the graft. Thus, the changes of corneal endothelial cell density after surgery are significant in predicting the prognosis. This article elaborates on the changes of endothelial cell density after endothelial keratoplasty and related influencing factors, aiming to provide reference and basis for clinical diagnosis and treatment.

摘要： 目的 分析始发于角膜深基质或内皮面的真菌感染的临床特征及其诊断与治疗效果.方法 回顾性病例系列研究.分析2009年1月至2015年6月因真菌性角膜炎在山东省眼科研究所青岛眼科医院住院的1 006例患者的临床资料,选择就诊时角膜上皮完整、角膜病灶位于深基质及内皮面的患者9例.其中男性6例,女性3例.年龄40～74岁,平均54.8岁.对9例患者的病史、致病诱因,体征,诊断经过,治疗经过及治疗效果进行总结分析.结果 5例患病前有植物性外伤病史,2例有非植物外伤史,2例无明显诱因.从患病到来我院就诊的时间均在3个月以上,平均7.9个月,最长为2年.临床表现主要为患眼红、痛反复发作,伴轻度视力下降.主要体征为角膜内皮面及深基质的白色混浊浸润,伴有内皮斑和前房炎性反应,角膜浅基质和上皮完整.5例患者在外院误诊为葡萄膜炎,给予糖皮质激素治疗;2例误诊为病毒性角膜炎,给予抗病毒药物及糖皮质激素治疗;2例误诊为细菌性角膜炎,给予抗生素治疗.来我院就诊时视力0.1者4例,0.3者1例,0.5者2例,0.6者2例.6例通过共焦显微镜检查查出角膜内皮面和深基质有菌丝,3例阴性.对这些患者给予了局部抗真菌药物滴眼,及结膜下、基质内、前房内注射伏立康唑治疗均无效,最终均进行了穿透性角膜移植术.术中取下的病变角膜真菌培养5例阳性,分别为链铬孢霉菌2例,无孢霉、疣状瓶霉、镰刀菌各1例.另外4例分别通过组织病理学检查、内皮斑10％KOH湿片镜检找到菌丝.结论 角膜后部真菌感染以角膜深基质浸润及内皮斑为主要表现.患者通常有植物外伤史,共聚焦显微镜检查是早期明确诊断的重要方法.抗真菌药物的渗透性差,药物治疗往往无效,病程迁延,最终仍需行穿透角膜移植术治疗.%Objective To evaluate the clinical features of retrocomeal fungal infection and the therapeutic effects.Methods This was a retrospective,noncomparative study of nine patients with retrocorneal fungal infection and an intact corneal epithelium treated at Qingdao Eye Hospital.The history,clinical features,diagnostic methods,pathogens and therapeutic effects were analyzed.Results Five patients had a history of trauma by plant,two had a non-plant injury,and two had unidentified reasons.The duration between the initial onset and the first visit to our hospital was 7.9 months (range,3 months to 2 years).There was endothelial plaque and sometimes with white infiltration in the deep stroma,but the corneal epithelium remained integrated,and the anterior stroma was uninfected.The patients were misdiagnosed as uveitis,herpes simplex keratitis or bacterial keratitis in the other hospitals.Visual acuity was 20/200 in four eyes,20/60 in one eye,20/40 in two eyes,and 20/30 in two eyes.Fungal hyphae were detected by confocal microscopy in six eyes.All the eyes had poor response to the antifungal medication before penetrating keratoplasty was performed.The smear examinations of the corneal eudothelial plaque showed fungal hyphae in six eyes.Alternaria Nees,Apospory,Phialophora verrucosa,and Fusarium were identified.Conclusions Plant injury is the most common risk factor of retrocorneal fungal infection.Slow onset and no initially obvious symptoms may lead to delayed diagnosis and misdiagnosis.The diagnosis can be confirmed by confocal microscopy before surgery.The effect of antifungal medication is usually poor.

摘要： Objective To construct a tissue-engineered human corneal endothelium with normal morphology,histological property,and evaluate its functions in monkey models.Methods Experimental study.Tissue-engineered HCE (TE-HCE) was constructed by culturing monoclonal human corneal endothelial cells (mcHCE cells) on mdAMs in 20％ fetal bovine serum-containing DMEM/Ham's Nutrient Mixture F12 (1∶1) medium and 5％ CO2 at 37 °C on a 24-well culture plate.The constructed TE-HCE and mdAM were transplanted into monkey corneas via penetrating keratoplasty with Descemet's membrane and endothelium stripped 3 right eyes respectively,left eyes as normal control eyes (6 eyes).The corneal transparency,endothelial cell density,thickness and intraocular pressure were monitored in vivo.Data were analyzed for statistical significance with one way analysis of variance (ANOVA).Results The constructed TE-HCE,with an average density of 3 602±45 cells/mm2,mimicked its natural counterpart both in morphology and histological structure.In vivo,corneal transparency was maintained with the density of 2 796±157 cells/mm2,and the corneal thickness gradually decreased after TE-HCE transplanted into monkey eyes,while intense corneal edema and turbid were found in mdAM-transplanted eyes with their corneal thicknesses increased during the monitoring period.Besides,the cells in transplanted area of corneal endothelium,with CM-DiI label,were all the seeder cells from constructed TE-HCE.Conclusion The constructed TE-HCE has normal histological property and functions well in monkey models.The TE-HCE could be used as a promising HCE equivalent in therapy of corneal endothelium dysfunction and corneal regenerative medicine.%目的 体外构建出形态结构功能正常的组织工程人角膜内皮(TE-HCE),并以猕猴动物模型验证其维持角膜透明的作用.方法 实验研究.以非转染人角膜内皮单克隆细胞株细胞(mcHCE细胞)为种子细胞,以去上皮层修饰羊膜(mdAM)为载体支架体外构建出TE-HCE,对其透明度、形态、细胞密度、组织学结构、超微结构、功能蛋白的荧光表达进行检测;采用穿透性角膜移植手术(PKP)对猕猴右眼分别移植TE-HCE(3眼,TE-HCE组)和mdAM(3眼,mdAM组),未移植的左眼作为正常对照眼(6眼,对照组),利用裂隙灯显微镜、角膜内皮镜、角膜测厚仪和眼压计对术后动物的角膜透明度、角膜内皮细胞密度(ECD)、中央角膜厚度(CCT)和眼压(IOP)进行在体检测,并利用荧光显微镜检测移植眼角膜内皮细胞的CM-DiI标记.数据处理均采用单因素方差分析.结果 体外构建的TE-HCE透明度高,具有与活体角膜内皮近似的形态结构,单层细胞密度高达(3 602±45)个/mm2,细胞连接蛋白和膜运输蛋白呈阳性表达;术后跟踪观测结果显示,TE-HCE移植眼的角膜没有出现明显的炎症和免疫排斥反应,角膜维持透明,虽然出现了轻度角膜水肿,但随着时间的推移CCT逐渐下降,术后181 d时单层细胞密度为(2 796±157)个/mm2;而mdAM移植眼的角膜则出现了明显的炎症反应,长人了新生血管,角膜持续混浊与水肿,厚度没有明显的下降趋势;各组间lOP的变化无明显差异.CM-DiI荧光检测结果显示TE-HCE移植眼的角膜内皮移植区的细胞均带有CM-DiI标记(来自于移植的TE-HCE).结论 体外构建的高密度TE-HCE具有正常的形态结构,且功能蛋白表达正常,移植后能使猕猴角膜逐渐恢复透明度和厚度,表明TE-HCE在体内可重建出功能正常的角膜内皮,有望用于角膜内皮异常疾病的临床治疗.

摘要： 目的：探讨N-芐基-2-（嘧啶-4-基氨基）（Thiazovivin）对人角膜内皮细胞（HCEC）形态和功能的影响。方法实验研究。培养原代HCEC，采用光镜观察细胞形态及神经元特异性烯醇化酶（NSE）的免疫荧光实验进行鉴定。以N-钙黏着蛋白（N-cadherin）和钠钾泵（Na+/K+-ATPase）为指标，通过免疫荧光实验考察添加不同浓度（0、2、4、6μmol/L）Thiazovivin作用不同时间（24及48 h）对原代HCEC形态和离子泵功能的影响，以期筛选出改善HCEC形态和离子泵功能效果最佳的Thiazovivin的浓度及作用时间。最后通过免疫荧光实验和免疫印迹实验考察Thiazovivin对Rho相关激酶（ROCK）表达的影响。结果培养的原代HCEC的NSE染色均匀，荧光强度明显，细胞呈六边形紧密排列。原代HCEC在0、2、4、6μmol/L的Thiazovivin分别作用24 h后，Na+/K+-ATPase抗体染色后的平均吸光度（A）值分别为1.27±0.08、3.72±0.17、21.07±4.67、3.69±0.34，4μmol/L的Thiazovivin的Na+/K+-ATPase免疫荧光表达最强，其A值最大；通过N-cadherin免疫荧光染色，发现HCEC在4μmol/L Thiazovivin作用24 h后，细胞轮廓清晰，细胞结构完整。而4μmol/L的Thiazovivin作用时间延长至48 h，通过N-cadherin和Na+/K+-ATPase免疫荧光染色，发现与其作用24 h相比，荧光强度无明显变化，但细胞排列比24 h时略整齐。此外，Thiazovivin能减弱ROCK免疫荧光染色的荧光强度及下调ROCK蛋白表达。结论 Thiazovivin对原代HCEC的形态、连接和离子泵功能具有保护作用，4μmol/L Thiazovivin作用24 h对细胞形态、连接及离子泵功能的改善效果最佳，且Thiazovivin可显著抑制ROCK蛋白表达。（中华眼科杂志，2016，52：686-692）%Objective To evaluate the effect of thiazovivin, a novel ROCK inhibitor, on the morphology and function of human corneal endothelial cells (HCECs). Methods The primary HCECs were identified by light microscopy and immunofluorescence staining of neuron-specific enolase. To screen the optimal concentration and action time of thiazovivin for maintaining the morphology and function of primary HCECs, Na +/K +-ATPase and N-cadherin were chosen as indicators, and the morphology and function of HCECs in various concentrations (0 μmol/L, 2 μmol/L, 4 μmol/L, and 6 μmol/L) for different durations (24 h and 48 h) were examined by immunofluorescence experiments. The effect of thiazovivin on the expression of ROCK was investigated by immunofluorescence and Western blot. Results The primary HCECs cultured were hexagonal, closely packed, homogeneously and obviously stained by neuron-specific enolase. The immunofluorescence staining of Na+/K+-ATPase showed that when the primary HCECs cultured with various concentrations of thiazovivin (0, 2, 4, 6μmol/L) for 24 h, the fluorescence were obvious, and the average absorbance values (A) were 1.27 ± 0.08, 3.72 ± 0.17, 21.07 ± 4.67, 3.69 ± 0.34, respectively. And the immunofluorescence staining of N-cadherin revealed that when the primary HCECs treated with 4 μmol/L thiazovivin for 24 h, the cell boundary was clear and the structure of the cells was intact. While the treating time of thiazovivin (4 μmol/L) on HCECs extended to 48 h, the immunofluorescence staining of Na+/K+-ATPase and N-cadherin showed that compared to HCECs treated with thiazovivin (4μmol/L) for 24 h,the fluorescence intensity did not change significantly, but the cells arranged slightly untidy. In addition, the immunofluorescence staining of ROCK was weakened and the expression of ROCK was reduced by thiazovivin. Thiazovivin was effective for protecting the morphology and function of HCECs. An optimal improvement in the morphology, connection and function of HCECs was found when the primary HCECs were cultured with 4 μmol/L thiazovivin for 24 h. Moreover, the expression of ROCK protein could be significantly inhibited by thiazovivin.

摘要： 目的 评估飞秒激光辅助超声乳化白内障吸除手术的安全性及有效性.方法 病例对照研究.2013年4月至11月在厦门眼科中心行超声乳化白内障手术的患者233例(314只眼),将其分为飞秒激光组(153只眼)及传统超声乳化组(161只眼),比较两组术前一般情况,术中超声乳化能量释放量(CDE)、有效超声时间(EPT)、角膜内皮丢失量、房水闪光值及术后并发症.计量资料采用独立样本t检验;计数资料采用交互列表的卡方或者Fisher确切概率法分析.结果 两组术前一般情况(年龄、性别、眼压、眼轴、角膜曲率、前房深度、核分级)差异无统计学意义(P＞0.05).飞秒激光组CDE、EPT分别为4.78％(3.18％～8.88％)和14.05 s(10.07 ～ 20.85 s),小于传统超声乳化组的8.82％(6.01％～19.16％)和23.65 s(18.36 ～ 46.96 s),差异有统计学意义(z=2.30,2.91;P＜0.05).飞秒激光组撕囊相对直径和圆形度均较传统超声乳化组更精确(t=2.58,3.92;P＜0.05).角膜内皮丢失量在术后1个月时飞秒激光组为73.50(-69.51～ 111.03)个/mm2,低于传统超声乳化组的118.06(53.55～299.03)个/mm2,差异有统计学意义(z=2.44;P＜0.05).房水闪光值在术后1d激光组18.81(13.32～20.23) ph/ms,传统超声乳化组24.51(16.38～ 32.18) ph/m和1个月时飞秒激光组13.01(9.23～ 16.28) ph/ms,传统超声乳化组18.05(12.37～ 24.97) ph/ms,传统超声乳化组均高于飞秒激光组,差异有统计学意义(z=2.40,2.31;P＜0.05).两组术后均无严重并发症出现.结论 飞秒激光辅助超声乳化白内障吸除手术具有较高安全性及有效性,可降低CDE和减少EPT,进而减少角膜内皮损伤和术后前房反应,且撕囊更精确、重复性更好.%Objective To evaluate the safety and effectiveness of femtosecond laser-assisted cataract surgery.Methods The interventional case series enrolled 314 eyes undergoing cataract surgery in Xiamen Ophthalmic Center between April and December 2013,patients were randomized to femtosecond laser-assisted cataract surgery(153 eyes) and conventional phacoemulsification cataract surgery(161 eyes).The clincic parameters of preoperation,during operation and postoperation were compared and statistically studied.Quantitative data were analyzed using the analysis of variance,independent t tests.Qualitative datawere analyzed using the crosstabs analysis chi-square test or the Fisher's exact test.Results The patient's demographics parameters(age,gender,IOP,axial length,mean keratometry,AC depth,Cataract grade) did not differ significantly between groups (P＞0.05).The CDE showing 4.78％ (3.18％-8.88％)and EPT showing 14.05 s (10.07-20.85 s)in the laser group were significantly lower than the CDE showing 8.82％ (6.01％-19.16％) and EPT showing 23.65 s (18.36-46.96 s) in the conventional group (z=2.30,2.91;P＜0.05).The relative diameter and circularity in laser-assisted capusulotomies were significantly more accurate (t=2.58,3.92;P＜0.05).The corneal endothelial cell loss showing 73.50 (-69.51-111.03)/mm2 was significantly lower in the laser group than the loss of 118.06 (53.55-299.03)/mm2 in the conventional group 1 month postoperatively (z=2.44;P＜0.05).Postoperative anterial chamber flare was significantly greater in the conventional group at 1 day of 18.81 (13.32-20.23) ph/ms in laser group,24.51(16.38-32.18)ph/m in conventional group and at 1 month of 13.01(9.23-16.28) ph/ms in laser group,18.05(12.37-24.97) ph/ms in conventional group than the laser group (z=2.40,2.31;P＜0.05).There were no severe surgical complications for both groups.Conclusions The femtosecond laser-assisted cataract surgery was effective and safe.It reduced EPT and CDE during operation,therefore decreased endothelial damage and postoperative anterior chamber inflammation.It also provided more precise and reproducible capsulotomies.

摘要： 目的 观察白内障超声乳化手术灌注液中不同浓度肾上腺素的散瞳效果及对角膜内皮细胞的影响,探讨临床应用肾上腺素的合理浓度.方法 选择单纯老年性白内障患者105例(120眼),随机分为A、B、C3组,每组40眼,500 mL灌注液中分别加入0.1 mL、0.2 mL、0.5 mL1‰肾上腺素注射液,均行白内障超声乳化吸除加折叠式人工晶状体植入手术,应用非接触型角膜内皮检测仪于术前及术后1周检测角膜内皮细胞密度、角膜内皮六角形细胞比例及角膜内皮细胞变异系数.结果 3组均能使术中瞳孔直径大于或等于手术开始时水平.术前3组角膜内皮细胞密度、角膜内皮六角形细胞比例、角膜内皮细胞变异系数差异无统计学意义(P＞0.05).术后1周,B组、C组角膜内皮细胞密度、角膜内皮六角形细胞比例低于术前(P＜0.05),A组与术前差异无统计学意义(P＞0.05),且3组间差异无统计学意义(P＞0.05).C组角膜内皮细胞变异系数高于术前(P＜0.05),A组、B组角膜内皮细胞变异系数与术前差异无统计学意义(P＞0.05),C组角膜内皮细胞变异系数高于A组(P＜0.05).结论 由于肾上腺素的潜在毒性作用,白内障超声乳化手术中500 mL灌注液应加入0.1 mL1‰肾上腺素维持术中扩瞳.

摘要： 用于执行小切口DLEK的系统、设备和方法包括提供角膜移植供体组织移植体；随后使用柔性的基层将组织移植体形成为可植入的构造。还描述了用于形成紧凑的或滚卷的组织移植体的相关的医用套件和工具。

摘要： 本发明公开了在合成自生物聚合物的基质的内皮侧上粘附并生长单层的培养的人角膜内皮细胞以产生更为生物等效的人工角膜的方法。该方法将包括使用粘附或者生长促进剂如纤连蛋白、层粘连蛋白、RGDS、IV型胶原蛋白、与聚卡波非缀合的bFGF，和与聚卡波非缀合的EGF。本专利还描述了生成自给聚合物的方法，该聚合物含有粘附分子和生长因子以支持培养的人角膜内皮细胞的粘附和增殖来用于角膜移植，其可以作为半厚度装置或者全厚度的钮替代物。本发明公开了一种用于将培养的角膜色素内皮(PRE)细胞植入到视网膜下空间以用于治疗年龄相关的黄斑变性(ARMD)的方法。该方法将使得递送单层细胞片中的移植的RPE成为可能，并且更适于发挥它们的生理功能。

摘要： 用于执行小切口DLEK的系统、设备和方法包括提供角膜移植供体组织移植体；随后使用柔性的基层将组织移植体形成为可植入的构造。还描述了用于形成紧凑的或滚卷的组织移植体的相关的医用套件和工具。

摘要： 本发明涉及一种基于人角膜基质为载体的角膜内皮膜片，所述作为载体的人角膜基质的平均厚度为20‑100μm，优选为20‑70μm；所述载体上具有阻隔水和促进细胞粘附的修饰层，在所述修饰层上面接种有角膜内皮细胞。本发明通过采用平均厚度更薄的人角膜基质，由此能够将一个供体材料切削为几个薄片，既发挥了供体材料的最大价值，又能为内皮膜片的构建提供了很好的支架材料。

摘要： 本发明公开了一种角膜基质内人工角膜内皮及其制备方法。制备方法包括如下步骤：干态硅水凝胶模胚的制备：将硅水凝胶单体聚合为干态硅水凝胶模胚；车削成型：将干态硅水凝胶模胚固定在数控车床上，车削出人工角膜内皮，它的前表面曲率半径与角膜前表面一致，后表面曲率半径与角膜后表面接近；抛光、水合：再将人工角膜内皮前、后表面抛光，修整，在生理盐水中充分水合，形成胶态角膜内皮。本发明突破了角膜内皮移植必须依赖高质量捐献人角膜的瓶颈，而且，人工角膜内皮植入患者角膜基质层间，既不发生人工角膜脱出，又不干扰眼内，非常安全。

摘要： 本发明属于医疗器械技术领域，具体涉一种用于辅助角膜内皮移植术的磁性角膜接触镜，该器械由镜身上表面、镜身下表面、径向边抬、轴向边抬、镜片孔、强力磁片组成。其中镜身由硬性透氧性材料通过模铸成型的方式一体成型，把强力磁片包裹在其中。镜身之中附有穿透的镜片孔两个，便于以眼科镊进行抓捏来戴取该角膜接触镜。本发明实用方便，操作简单，符合角膜内皮移植手术后佩戴要求。

摘要： 本发明公开了一种诱导形成角膜内皮样细胞的方法，所述的方法包括步骤：将2－8×104个/ml的骨髓内皮祖细胞(bone marrow derived endothelial progenitorcells，BEPCs)和0.6－3×105个/ml的角膜内皮细胞(coneal endothlial cell，CECs)共培养，使骨髓内皮祖细胞分化形成角膜内皮样细胞。本发明还公开了一种由所述方法得到的角膜内皮样细胞构建的角膜后板层及其制备方法和用途。

摘要： 本发明公开了在合成自生物聚合物的基质的内皮侧上粘附并生长单层的培养的人角膜内皮细胞以产生更为生物等效的人工角膜的方法。该方法将包括使用粘附或者生长促进剂如纤连蛋白、层粘连蛋白、RGDS、IV型胶原蛋白、与聚卡波非缀合的bFGF，和与聚卡波非缀合的EGF。本发明还描述了生成自给聚合物的方法，该聚合物含有粘附分子和生长因子以支持培养的人角膜内皮细胞的粘附和增殖来用于角膜移植，其可以作为半厚度装置或者全厚度的钮替代物。本发明公开了一种用于将培养的角膜色素内皮(PRE)细胞植入到视网膜下空间以用于治疗年龄相关的黄斑变性(ARMD)的方法。该方法将使得递送单层细胞片中的移植的RPE成为可能，并且更适于发挥它们的生理功能。

摘要： 提供了一种用于制造内皮角膜移植物的方法。所述方法包括：提供供体角膜；用激光辐射从所述供体角膜的内皮侧照射所述供体角膜以在所述辐射的焦点处在所述供体角膜的组织中引起光致破裂；以及移动所述辐射的所述焦点以在所述供体角膜中形成内皮移植物。通过从所述供体角膜的内皮侧而不是上皮侧照射所述供体角膜来切割所述内皮移植物，可在死亡后在所述供体角膜的基质组织中产生的光学不均匀性使激光切割过程基本上不受影响。

摘要： 提供了一种用于制造内皮角膜移植物的方法。所述方法包括：提供供体角膜；用激光辐射从所述供体角膜的内皮侧照射所述供体角膜以在所述辐射的焦点处在所述供体角膜的组织中引起光致破裂；以及移动所述辐射的所述焦点以在所述供体角膜中形成内皮移植物。通过从所述供体角膜的内皮侧而不是上皮侧照射所述供体角膜来切割所述内皮移植物，可在死亡后在所述供体角膜的基质组织中产生的光学不均匀性使激光切割过程基本上不受影响。