Purpose To assess clinical follow-up data, and to identify donor epithelial c ells after homologous penetrating central limbo-keratoplasty in patients with g ranular and lattice corneal dystrophies compared with patie...
Purpose To assess clinical follow-up data, and to identify donor epithelial c ells after homologous penetrating central limbo-keratoplasty in patients with g ranular and lattice corneal dystrophies compared with patients who underwent con ventional penetrating keratoplasty (PK). Design Mixed retrospective and prospect ive nonrandomized comparative case series. Participants and controls Twenty-six patients who underwent 33 limbo-keratoplasty procedures for granular or lattic e corneal dystrophy since May 1995 and a historical control group of 24 patients who underwent 36 PK procedures between November 1986 and May 1995. Methods Post operatively, all but 2 limbo-keratoplasty patients were treated with systemic i mmunosuppressants for 6 months. All patients received long-term topical immunep rophylaxis with prednisolone-21-acetate 1%(2 drops per day). After obtaining informed consent, epithelial cells were harvested from 10 limbo-keratoplasty ey es of 8 patients with granular dystrophy and 7 limbo-keratoplasty eyes of 7 pat ients with lattice dystrophy. Conjunctival epithelium or buccal mucosal epitheli um for recipient identification and corneal epithelial cells from 3 graft sites were harvested. Deepfrozen donor corneoscleral rims were analyzed to characteriz e donor features. Genetic analysis was performed by polymerase chain reaction of short tandem repeat (STR) loci. Main outcome measures The ratio of dystrophy re currences in the graft was clinically assessed. Donor features in epithelial cel ls were genetically established if at least 1 STR profile differed from that of the recipient. Resuits There were 5 recurrences in limbokeratoplasty eyes with g ranular dystrophy and 2 recurrences in limbo-keratoplasty eyes with lattice dys trophy, compared with 15 and 6 recurrences in PK eyes, respectively. The differe nces between limbo-kera- toplasty and PK were not staistically significant over time (log-rank test; P =0.14 for granular dystrophy and P=0.56 for lattice dy
暂无评论