中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2011年
9期
940-944
,共5页
余乐初%马慧香%陈俊%邓姿峰%孙莉%陈蔚
餘樂初%馬慧香%陳俊%鄧姿峰%孫莉%陳蔚
여악초%마혜향%진준%산자봉%손리%진위
穿透性角膜移植%偏心性角膜穿孔%甘油保存%小植片
穿透性角膜移植%偏心性角膜穿孔%甘油保存%小植片
천투성각막이식%편심성각막천공%감유보존%소식편
Penetrating keratoplasty%Eccentric corneal perforation%Glycerin-cryopreserved graft%Small diameter
目的 评价甘油保存角膜的小植片穿透性角膜移植治疗偏心性角膜穿孔的临床疗效。方法 回顾性分析2007年11月1日至2010年4月30日期间因偏心性角膜穿孔在温州眼视光医院应用甘油保存角膜行小植片穿透性角膜移植的连续病例12例（12只眼）。随访观察视力变化、术后角膜地形图和角膜内皮细胞数，记录并发症的发生和转归。结果 所有患眼均获得临床治愈，眼球完整性得以保持。末次随访裂隙灯检查示3例(25％)植片透明，其它患者的植片轻度混浊。术后裸眼视力较术前裸眼视力有明显提高(P =0.002)，术后最佳矫正视力大于0.8者占50％。术后角膜散光平均为(-2.12±1.27)D。末次随访角膜内皮细胞数量平均为（2570±495）cells/mm2。所有患者均未发现免疫排斥反应、继发性青光眼、并发性白内障等并发症。结论 应用甘油保存角膜的小植片穿透性角膜移植能安全有效地治疗偏心性角膜穿孔，提高视力，避免术后并发症的发生。甘油角膜满足了角膜穿孔急诊手术的需要，也缓解了新鲜角膜缺乏的现状。
目的 評價甘油保存角膜的小植片穿透性角膜移植治療偏心性角膜穿孔的臨床療效。方法 迴顧性分析2007年11月1日至2010年4月30日期間因偏心性角膜穿孔在溫州眼視光醫院應用甘油保存角膜行小植片穿透性角膜移植的連續病例12例（12隻眼）。隨訪觀察視力變化、術後角膜地形圖和角膜內皮細胞數，記錄併髮癥的髮生和轉歸。結果 所有患眼均穫得臨床治愈，眼毬完整性得以保持。末次隨訪裂隙燈檢查示3例(25％)植片透明，其它患者的植片輕度混濁。術後裸眼視力較術前裸眼視力有明顯提高(P =0.002)，術後最佳矯正視力大于0.8者佔50％。術後角膜散光平均為(-2.12±1.27)D。末次隨訪角膜內皮細胞數量平均為（2570±495）cells/mm2。所有患者均未髮現免疫排斥反應、繼髮性青光眼、併髮性白內障等併髮癥。結論 應用甘油保存角膜的小植片穿透性角膜移植能安全有效地治療偏心性角膜穿孔，提高視力，避免術後併髮癥的髮生。甘油角膜滿足瞭角膜穿孔急診手術的需要，也緩解瞭新鮮角膜缺乏的現狀。
목적 평개감유보존각막적소식편천투성각막이식치료편심성각막천공적림상료효。방법 회고성분석2007년11월1일지2010년4월30일기간인편심성각막천공재온주안시광의원응용감유보존각막행소식편천투성각막이식적련속병례12례（12지안）。수방관찰시력변화、술후각막지형도화각막내피세포수，기록병발증적발생화전귀。결과 소유환안균획득림상치유，안구완정성득이보지。말차수방렬극등검사시3례(25％)식편투명，기타환자적식편경도혼탁。술후라안시력교술전라안시력유명현제고(P =0.002)，술후최가교정시력대우0.8자점50％。술후각막산광평균위(-2.12±1.27)D。말차수방각막내피세포수량평균위（2570±495）cells/mm2。소유환자균미발현면역배척반응、계발성청광안、병발성백내장등병발증。결론 응용감유보존각막적소식편천투성각막이식능안전유효지치료편심성각막천공，제고시력，피면술후병발증적발생。감유각막만족료각막천공급진수술적수요，야완해료신선각막결핍적현상。
Objective To evaluate the clinical effect of small-diameter Penetrating Keratoplasty (PK) with glycerin-cryopreserved graft for the treatment of eccentric corneal perforation. Methods Retrospective analysis was performed on 12 consecutive cases (12 eyes) of eccentric corneal perforations which received small- diameter PKs with glycerin-cryopreserved grafts from November 1st, 2007 to April 30th, 2009 at Wenzhou Eye Hospital. Pre- and postoperative visual acuity, clarity of grafl postoperative corneal topographic result, postoperative endothelial cell density and complications were ana lyzed. Results All of the 12 cases achieved global integrity. Slit-lamp examination showed transparent grafts on 3 eyes (25％), while cloudy grafts were showed on the other eyes. A significant improvement in the uncorrected distance visual acuity (UDVA) were noted in all cases (P =0.002). Corrected distance visual acuity (CDVA) more than 0.8 were noted in 50％ of the cases. A mean value of keratometric astigmatism of (-2.12+ 1.27) diopters were detected in our cases. No immune rejection, secondary glaucoma and cataract were developed in all cases after surgery. The average corneal endothelial cell density was (2570± 495) cells per square millimeter. Conclusions The small-diameter PK with glycerin-cryopreserved graft for the treatment of eccentric corneal perforation is safe and efficient, which may be considered as an alternative to the fresh graft.
