移植用摘出眼球の角膜内皮細胞観察用Chamberとその臨床応用

Design of a chamber for observation of donor corneal endothelium and its clinical application

　角膜移植用摘出眼球の角膜内皮細胞をスペキュラーマイクロスコープにより観察するためのChamberを開発，移植術前，術後における内皮細胞の観察を行った．Chamberは眼球を容れる本体と角膜の湿潤を維持し，汚染を防ぐためのキャップと摘出後の低眼圧を機械的に矯正する装置を兼ねたキャップの3部からなる．内皮細胞はChamberに固定された全眼球の状態で角膜上皮側からスペキュラーマイクロスコピーにより観察された．対象とした摘出眼3例4眼の全眼で内皮細胞の観察が可能であった．移植眼4眼中3眼での術後11〜15日の内皮細胞の観察結果の術前に対する平均細胞密度減少率は18％であった．本Chamberは今後，角膜移植術前，術後の角膜内皮細胞の臨床的検討に有用であると考えられた．

We designed a whole eye chamber to evaluate the corneal endothelium of donor eye prior to kerato-plasty. The chamber is composed of three pieces. The anterior cap maintains a moist chamber. It can be removed for specular microscopy. The sec-ond piece is a cylinder with a collar which is used to secure apposition with the scleral limbus. The third piece is a posterior cap with an adjust-able plunger which corrects the intraocular pressure.

We examined 4 donor eyes of 3 cases thus kept in the chamber by specular microscopy. Endothelial cells could be clearly observed in each eye, with the cell density ranging from 3,056 to 3,624 per mm². We evaluated the corneal endothelium in 3 of the 4 eyes 11 to 15 days after keratoplasty. The loss rate of the endothelial cells averaged 18±9.0% (mean±s.d.)

The present device thus proved to be of clinical value in the selection of donor eye prior to kera-toplasty and also in the evaluation of the corneal endothelium after surgery.