CAJ | 학술논문

目的比较深板层角膜移植术(DLKP)和穿透性角膜移植术(PKP)两种术式治疗真菌性角膜溃疡的效果.方法回顾性系列病例研究.2004至2006年在宁波鄞州人民医院眼科中心临床诊断明确的真菌性角膜溃疡患者17例(17眼),其中8例行DLKP,平均年龄38.6岁,9例行PKP,平均年龄51.0岁.术后随访时间12～24个月,记录两组患者的最佳矫正视力、角膜屈光状态、角膜内皮计数及并发症.计数资料采用x2检验,计量资料采用独立样本t检验进行分析.结果两组患者术后的视力均较术前提高,最好的最佳矫正视力达1.0,两组差异无统计学意义.DLKP组术后散光小于PKP组,差异有统计学意义(x2=12.07,P<0.05),两组散光度均低于5.00 D.术后6个月、12个月角膜内皮细胞计数DLKP组较PKP组高,差异有统计学意义(t=3.899、7.618,P<0.05).深板层角膜移植患者排斥反应的发生率较穿透性角膜移植患者低(x2=132.26,P<0.01).结论真菌性角膜溃疡患者DLKP术后最佳矫正视力略优于PKP,角膜散光度比PKP低,并发症也较少.DLKP能减少排斥反应的发生,降低手术的失败率,是治疗真菌性角膜溃疡的一种安全有效的方法.
목적 비교심판층각막이식술(DLKP)화천투성각막이식술(PKP)량충술식치료진균성각막궤양적효과.방법 회고성계렬병례연구.2004지2006년재저파은주인민의원안과중심림상진단명학적진균성각막궤양환자17례(17안),기중8례행DLKP,평균년령38.6세,9례행PKP,평균년령51.0세.술후수방시간12～24개월,기록량조환자적최가교정시력、각막굴광상태、각막내피계수급병발증.계수자료채용x2검험,계량자료채용독립양본t검험진행분석.결과 량조환자술후적시력균교술전제고,최호적최가교정시력체1.0,량조차이무통계학의의.DLKP조술후산광소우PKP조,차이유통계학의의(x2=12.07,P<0.05),량조산광도균저우5.00 D.술후6개월、12개월각막내피세포계수DLKP조교PKP조고,차이유통계학의의(t=3.899、7.618,P<0.05).심판층각막이식환자배척반응적발생솔교천투성각막이식환자저(x2=132.26,P<0.01).결론 진균성각막궤양환자DLKP술후최가교정시력략우우PKP,각막산광도비PKP저,병발증야교소.DLKP능감소배척반응적발생,강저수술적실패솔,시치료진균성각막궤양적일충안전유효적방법.
Objective To compare the therapeutic effects of deep lamellar keratoplasty (DLKP) and penetrating keratoplasty (PKP) on fungal corneal ulcer. Methods This was a retrospective case series study. Seventeen eyes of 17 patients suffering from fungal corneal uncler treated in Yinzhou People's Hospital from 2004 to 2006 were analyzed, of these patients, 8 patients underwent DLKP (average 38.6 years), 9 patients underwent PKP (average 51.0 years), followed up for 12-24 months. Best corrected visual acuity (BCVA), refractive dioptor of corneal endothelium counting and complications were compared between the two groups. Data were analyzed with a x2 test or an independent samples t test. Results BCVA of both groups after the surgery were improved, the best BCVA was 1.0, difference between the two groups were without significance. The astigmatic dioptor of DLKP group were smaller than those of PKP group, difference was significant (x2=12.07, P＜0.05). The astigmatic dioptor of the both groups were less than 5.00 D. The endothelium counting showed DLKP group endothelium were more than PKP group, differences were significant at 6 months and 12 months (t=3.899, 7.618, P＜0.05). The exclusive reaction in DLKP group was less than that in PKP group, difference was significant (x2=132.26, P＜0.01). Conclusion Fungal corneal ulcer treated with DLKP results in better BCVA than PKP, less astigmatic dioptor, less complications. DLKP can reduce the occurrence of exclusive reaction of endothelium type, less failure rate.