기증 각막 한 개로 두 가지 각막이식술을 실시한 4예
Four Cases of Split Cornea Transplantation from a Single Cornea
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목적: 기증 각막 한 개를 이용하여 두 명의 환자에게 내피층각막이식술(descemet membrane keratoplasty, DMEK)과 심부표층각막이식술(deep anterior lamella keratoplasty, DALK)을 각각 실시한 4예를 보고하고자 한다. 증례요약: 기증각막 4개를 내피층과 나머지 조직으로 분리하였다. 내피층은 분리되는 즉시 4명의 수포성 각막병증 환자에게 각각 이식하였고, 나머지 조직은 각막보존액에 넣어서 보관하였다. 그 후 보존된 나머지 각막편으로 2명의 지질각막병증과 2명의 원추각막환자에게 각각 심부표층각막이식술을 시행하였다. 술 후 이식된 각막편은 8명의 환자에서 모두 안정적으로 관찰되었다. 결론: 기증 각막 한 개로 내피층은 내피층각막이식술을 실시하고 나머지 조직으로 심부표층각막이식술을 실시한 4예를 국내에서 처음으로 보고한다. 기증 각막이 부족한 우리나라에서 하나의 기증 각막으로 2명의 환자에게 시술함으로써 각막이식이 필요한 환자들에게 더 많은 혜택을 줄 수 있을 것으로 생각된다.
Abstract
Purpose: To report four cases of split cornea transplantation involving separate Descemet membrane keratoplasty and Deep anterior lamella keratoplasty from a single cornea. Case summary: Four donor corneas were separated into the endothelium and other layers. The endothelial layers were transplanted into 4 pseudophakic bullous keratopathy patients, and the other layers were stored in corneal storage media. Deep anterior lamella keratoplasties were performed with the stored corneas in 2 lipid keratopathy and 2 keratoconus patients. Postoperatively, all grafted corneas were stable. Conclusions: The authors report the first 4 cases of split cornea transplantation in Korea, which is experiencing a shortage of donated corneas. Split cornea transplantation will be of benefit to a large number of patients by separating a single cornea into separate layers to be implanted into two patients.
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