Niccolò Salgari, Angeli Christy Yu, Serena Panariello, Luigi De Rosa, Massimo Busin
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引用次数: 0
摘要
背景/目的利用共聚焦显微镜研究穿透性角膜移植术(PK)后眼中角膜前膜(DM)水平的自然分离平面在体内的存在。方法对20只pk后眼和20只角膜移植术初期健康对照眼的角膜基质进行体内共聚焦显微镜观察。患者在2022年6月至2024年2月期间从Ospedali Privati Forlì ‘ Villa Igea ’的角膜服务部门招募。该研究遵循了赫尔辛基宣言,并得到了当地伦理委员会的批准。主要观察指标为基质细胞密度(SCD)和细胞分布模式。结果pk后眼后部SCD明显高于对照组(387±96 vs 219±30细胞/mm²,p<0.0001)。在pk后的眼睛中观察到一层明显的角质细胞样细胞密集分布,对应于DM前可见的最后一行细胞核,但在对照组中没有。这些细胞的细胞核不规则地分散或聚集成簇,在某些情况下沿首选方向排列成柱状。结论:在pk后的眼睛中存在一种明显的dm前角质细胞样细胞层,可能有助于先前描述的重复角膜成形术期间的自然分离平面。需要进一步的研究来澄清这一发现的起源和临床意义。如有合理要求,可提供资料。
In vivo confocal microscopy confirms the presence of new predescemetic cellular layer in post-penetrating keratoplasty buttons
Background/aim To investigate the in vivo presence of a natural plane of separation at the pre-Descemet membrane (DM) level in post-penetrating keratoplasty (PK) eyes using confocal microscopy. Methods In vivo confocal microscopy was performed on the corneal stroma of 20 post-PK eyes and 20 keratoplasty-naive healthy control eyes. Patients were recruited from the cornea service of Ospedali Privati Forlì ‘Villa Igea’ between June 2022 and February 2024. The study adhered to the Declaration of Helsinki and was approved by the local ethics committee. Main outcome measures were stromal cell density (SCD) and the pattern of cell distribution. Results Posterior SCD was significantly higher in post-PK eyes compared with controls (387±96 vs 219±30 cell/mm², p<0.0001). A distinct layer densely populated by keratocyte-like cells, corresponding to the last visible row of nuclei before the DM, was observed in post-PK eyes but not in controls. Nuclei of these cells appeared irregularly dispersed or grouped in clusters, and in some cases arranged in columns along a preferred direction. Conclusions A distinct pre-DM layer of keratocyte-like cells is present in post-PK eyes potentially contributing to the previously described natural plane of separation during repeat keratoplasties. Further studies are needed to clarify the origin and clinical implications of this finding. Data are available on reasonable request.
期刊介绍:
The British Journal of Ophthalmology (BJO) is an international peer-reviewed journal for ophthalmologists and visual science specialists. BJO publishes clinical investigations, clinical observations, and clinically relevant laboratory investigations related to ophthalmology. It also provides major reviews and also publishes manuscripts covering regional issues in a global context.