CAJ | 학술논문

目的应用前节OCT(AS-OCT)对角膜内皮移植术(EK)术后植床和植片的位置关系进行观察.方法回顾性分析2007年9月-2009年4月北京大学眼科中心行角膜后弹力层剥除自动角膜刀取材内皮移植术(DSAEK)的患者42例(44眼),其中男30例,女12例;年龄15～83岁.术前术后分别行裂隙灯显微镜和AS-OCT检查,对比观察DSAEK术后植片与植床间的位置关系.结果 28例患者在裂隙灯显微镜和AS-OCT检查均可清晰地显示植片贴附于角膜后表面、植片位置居中;术后不同时间植片、植床的厚度处于动态变化,随着时间的推移,植床水肿逐渐消退,植片和植床越来越稳定,贴附得更紧密,厚度变得更薄,角膜透明度增加;早期植片完全脱位者5例,占11.36%;植片部分脱位者2例,占4.55%;植片中央贴附良好,周围卷边者1例,占2.27%;植片偏位者8例,占18.18%.结论 AS-OCT是评价EK术后植床和植片位置关系的有效工具.
목적 응용전절OCT(AS-OCT)대각막내피이식술(EK)술후식상화식편적위치관계진행관찰.방법 회고성분석2007년9월-2009년4월북경대학안과중심행각막후탄력층박제자동각막도취재내피이식술(DSAEK)적환자42례(44안),기중남30례,녀12례;년령15～83세.술전술후분별행렬극등현미경화AS-OCT검사,대비관찰DSAEK술후식편여식상간적위치관계.결과 28례환자재렬극등현미경화AS-OCT검사균가청석지현시식편첩부우각막후표면、식편위치거중;술후불동시간식편、식상적후도처우동태변화,수착시간적추이,식상수종축점소퇴,식편화식상월래월은정,첩부득경긴밀,후도변득경박,각막투명도증가;조기식편완전탈위자5례,점11.36%;식편부분탈위자2례,점4.55%;식편중앙첩부량호,주위권변자1례,점2.27%;식편편위자8례,점18.18%.결론 AS-OCT시평개EK술후식상화식편위치관계적유효공구.
Background The advantages of endothelium keratoplasty(EK)include without corneal surface incision and sutures,remaining normal corneal topography,minimizing astigmatism and providing a healthy donor endothelial cell count and function.Using anterior segment optical coherence tomography(AS-OCT) to examine the morphology of the corneal graft after EK is helpful for the evaluation of the outcome of EK.ObjectiveThis study applies AS-OCT to observe the relationship of recipient cornea and donor graft and offer a basis for the evaluation of operative outcome.MethodsThe clinical data from 44 eyes of 42 patient who received DSAEK in Peking University Eye Center from September 2007 through April 2009 was reviewed retrospectively.These patients included 30 male and 12 female with the age from 15 to 83 years.Structure of cornea and relationship between recipient cornea and graft disc after surgery were clinically examined and recorded by slit-lamp digital camera and AS-OCT.This study was approved by the Ethics Committee of Peking University.Written informed consent was obtained from all of the patients before the operation.ResultsThe donor graft attached to posterior central surface of recipient in 28 eyes under the slit-lamp microscopy and AS-OCT.The thickness of donor graft was decreased,and graft sticked more closely to recipient cornea and was more transparent with the lapse of time.Complete dislocation of the donor graft in early stage was found in 5 eyes(11.36%) and partial dislocation in 2 eyes(4.55%).Curliness of graft edge occurred in 1 eye(2.27%) and eccentricity of donor graft in 8 eyes(18.18%).ConclusionAS-OCT can display the morphology and structure of cornea as well as the relationship between donor graft and recipient after DSAEK.It is helpful for evaluating the clinical effectiveness of DSAEK.