CAJ | 학술논문

目的探讨光学性穿透性角膜移植术后眼球屈光状态变化的规律.方法对圆锥角膜、角膜白斑、角膜营养不良采用不同直径大小角膜植片进行部分穿透性角膜移植术,术后随访2年.结果术后角膜植片透明,视力恢复但残留屈光不正者较多,矫正视力明显好于裸眼视力.术后早期散光较大,随时间延长,散光逐渐减小,角膜植片与植床趋近于正常生理状态.术后不同时间植片大的一组术后散光明显少于植片小的一组(P＜0.05).与术前相比,术后眼轴变短,(P＜0.05).植片与植床等大的一组眼轴缩短较植片大于植床0.25 mm的一组明显(P＜0.05).结论术后视力普遍提高,眼轴变短,散光明显.植片与植床的差值越小,眼轴缩短越明显.植片越小、散光越大.角膜植片大小的选择,植片与植床的匹配,拆线时机的选择,熟练的缝合技术,可以影响术后眼球的屈光状态,对提高光学性角膜移植术的效果具有重大意义.
목적 탐토광학성천투성각막이식술후안구굴광상태변화적규률.방법 대원추각막、각막백반、각막영양불량채용불동직경대소각막식편진행부분천투성각막이식술,술후수방2년.결과 술후각막식편투명,시력회복단잔류굴광불정자교다,교정시력명현호우라안시력.술후조기산광교대,수시간연장,산광축점감소,각막식편여식상추근우정상생리상태.술후불동시간식편대적일조술후산광명현소우식편소적일조(P＜0.05).여술전상비,술후안축변단,(P＜0.05).식편여식상등대적일조안축축단교식편대우식상0.25 mm적일조명현(P＜0.05).결론 술후시력보편제고,안축변단,산광명현.식편여식상적차치월소,안축축단월명현.식편월소、산광월대.각막식편대소적선택,식편여식상적필배,탁선시궤적선택,숙련적봉합기술,가이영향술후안구적굴광상태,대제고광학성각막이식술적효과구유중대의의.
Objective To explore the refraction changes after penetrating keratoplasty.Methods 65 cases (68 eyes) underwent penetrating keratoplasty with diagnoses as keratoconus,corneal leukoma or corneal dystrophy.The patients were followed up for 2 years.Results All grafts were transparent after sugery.The visual acuities were improved in all cases,however most patients had residual ametropia.The corrected visual acuities were better than the naked vision.The astigatism was bigger at the early stage after surgery.As time went by,the astigmatism became smaller.The graft and the plant bed had the tendency to recover to the normal physiological condition.The astigmatism was smaller in the group with large graft than that in the group with small graft at different time points after surgery (P ＜ 0.05).The axial length became shorter after sugery compared with the preoperative values (P ＜ 0.05).The shortage of axial length was larger in the group with equal size of graft and bed than the group in which the graft was bigger than the bed 0.25 mm (P ＜ 0.05).Conclusion The patients have better vision,shorter axial length and larger astigmatism after keratoplasty.The closer of the size of the graft and bed are,the more shortening of the axial length becomes.The eyeball with smaller graft usually has larger astigmatism.Suitable size of the corneal graft,the match of the graft and bed,time of removing sutures and skill of suturing are the factors which influence the refraction after keratoplasty.