Turkiye Klinikleri Journal of Ophthalmology

Keratokonüslü Olgularda Donör Kornea Seçimi
SELECTION OF DONOR CORNEA FOR PATIENTS WITH KERATOCONUS
Mustafa ONAT*, Ayşe Burcu NURÖZLER**, Sabahattin BOZKURT***, Bekir Sıtkı ASLAN**, Sunay DUMAN****
* Op., S.B.Ankara Eğitim ve Araştırma Hastanesi Göz Kliniği, Başasis.**, Doç., S.B.Ankara Eğitim ve Araştırma Hastanesi Göz Kliniği, Şef Muav.***, Op., S.B.Ankara Eğitim ve Araştırma Hastanesi Göz Kliniği, Asis.****, Op., S.B.Ankara Eğitim ve Araştırma Hastanesi Göz Kliniği, Şefi, ANKARA
Turkiye Klinikleri J Ophthalmol. 2003;12(1):9-14
Article Language: TR
Full Text
ÖZET
 Amaç: Keratokonüs nedeniyle penetran keratoplasti ( PKP ) yapılan olgularda donör yaşı, ölüm-alınma zamanı, alınmanakil zamanı, donör kornea kalitesinin greft rejeksiyonuna etkisini araştırmak.Gereç ve Yöntem: Keratokonüs nedeniyle PKP yapılan 40 hastanın 40 gözü retrospektif olarak incelendi. Yaş ortalaması 22.7 ± 7.8 (13-48), ortalama takip süresi 27.5 ± 19 (12-59) aydı. Donör kornealar hastanemiz morgundan IFETB ( International Federation of Eye and Tissue Banks) standartlarına uygun olarak alındı. MK veya Optisol solüsyonda saklandı. Ortalama ölüm-alınma süresi 4.17 ± 3.2 (1-8) saatti. Donör kornealar biyomikroskop ile muayene edilerek IFETB standartlarına göre; mükemmel, çok iyi, iyi, orta, kullanılmaz, olarak sınıflandırıldı. İyi, çok iyi, mükemmel olanlar transplantasyonda kullanıldı. Donörlerin en genci 10, en yaşlısı 65, ortalama 44.7 ± 9.4 yaşındaydı.Bulgular: 40 gözün 34ünde (%85) greft rejeksiyonu gelişmedi (Grup I). Bir gözde 3 kez, bir gözde 2 kez, 4 gözde 1 kez olmak üzere toplam 6 gözde (%15) greft rejeksiyon atağı gelişti (Grup II). Kornea kaliteleri ile greft rejeksiyonu gelişmesi arasında istatistiksel olarak anlamlı bir ilişki bulunmadı (p=0.8517). Donör kornea yaşı ile, greft rejeksiyonu gelişimi arasında da anlamlı bir ilişki yoktu (p=0.0653). Ölüm-alınma zamanı (p=0.6449), alınmanakil zamanı arasında da greft rejeksiyonu gelişimi açısından anlamlı bir fark bulunmadı (p=0.0848).Sonuç: IFETB standartlarında transplantasyon, keratokonüslü olgularda başarıyı arttırmaktadır. Donör kornea yaşı, ölüm-alınma zamanı, alınmanakil zamanının greft rejeksiyonu gelişmesi üzerine istatistiksel olarak anlamlı bir etkisi olmadığı görüldü.

Anahtar Kelimeler: Penetran keratoplasti, Keratokonüs, Greft rejeksiyonu
ABSTRACT
 SummaryObjective: The aim of this study was to determine the effects of donor age, death-excision time, excision to transplantation time, the quality of cornea on the graft rejection in the cases of penetrating keratoplasty due to keratoconus.Material and Method: 40 eyes of 40 patients who underwent penetrating keratoplasty due to keratoconus were examined retrospectively. Average age was 22.7 ± 7.8 (13-48), the mean follow up period was 27.5 ± 19 (12-59) months. Donor corneas were procurved from our hospitals morgue in accordance with the standarts of IFETB (International Federation of Eye and Tissue Banks). They were preserved in MK or Optisol solutions. Average death excision time was 4.17 ± 3.2 (1-8) hours. Donor corneas examined with biomicroscope and classified as excellent, very good, good, fair and not suitable for surgery. Good, very good and excellent ones were used in transplantations. The youngest donor was 10, the oldest was 65 years old, mean age was 44.7 ± 9.4 years.Results: Graft rejection was not observed in 34 (85%) of 40 eyes (group I). Graft rejection was observed in 6 eyes (15%) 3 times in one eye, twice in one eye and once in 4 eyes (group II). There was no significant statistical relationship between the quality of cornea and development of graft rejection (p=0.8517). There was also no significant difference between donor cornea age and development of graft rejection (p=0.0653). There was not a meaningful difference for graft rejection between death-excision time (p=0.6449) and excision-transplantation time (p= 0.0848) either.Conclusion: Transplantation under IFETB standarts increases the success in cases with keratoconus. It was observed that donor age, death-excision time, excision-transplantation time have no significant effect on the development of graft rejection.

Keywords: Penetrating keratoplasty, Keratoconus, Graft rejection

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