CAJ | 학술논문

背景:深板层角膜移植治疗圆锥角膜可显著提高视力,且并发症少,排斥反应率低,但对于瘢痕期圆锥角膜仍以部分穿透性角膜移植为主.目的:评价深板层角膜移植治疗瘢痕期圆锥角膜的临床疗效.方法:58例Ⅲ期、Ⅳ期有角膜瘢痕患者分为角膜浅基质层有角膜瘢痕形成患者37例(浅瘢痕组),角膜深基质层或全层有角膜瘢痕形成患者21例(深瘢痕组).58例患者行深板层角膜移植,移植后随访12个月,比较移植前后视力变化.结果与结论:所有患者角膜移植后裸眼视力与移植前比较均有明显提高.58只眼角膜植片均透明,其中1只眼角膜移植后2个月发生上皮型排斥反应,经药物治疗后恢复透明.深瘢痕组2例角膜移植后出现眩光,改做部分穿透性角膜移植.角膜移植后1年浅瘢痕组与深瘢痕组视力相比差异无显著性意义.提示深板层角膜移植治疗瘢痕期圆锥角膜可显著提高视力,且并发症少,排斥率低,是一种安全有效,长期疗效稳定的治疗方法,尤其对于大基底的圆锥角膜应作为首选方案.
배경:심판층각막이식치료원추각막가현저제고시력,차병발증소,배척반응솔저,단대우반흔기원추각막잉이부분천투성각막이식위주.목적:평개심판층각막이식치료반흔기원추각막적림상료효.방법:58례Ⅲ기、Ⅳ기유각막반흔환자분위각막천기질층유각막반흔형성환자37례(천반흔조),각막심기질층혹전층유각막반흔형성환자21례(심반흔조).58례환자행심판층각막이식,이식후수방12개월,비교이식전후시력변화.결과여결론:소유환자각막이식후라안시력여이식전비교균유명현제고.58지안각막식편균투명,기중1지안각막이식후2개월발생상피형배척반응,경약물치료후회복투명.심반흔조2례각막이식후출현현광,개주부분천투성각막이식.각막이식후1년천반흔조여심반흔조시력상비차이무현저성의의.제시심판층각막이식치료반흔기원추각막가현저제고시력,차병발증소,배척솔저,시일충안전유효,장기료효은정적치료방법,우기대우대기저적원추각막응작위수선방안.
@@@@BACKGROUND: Deep lamel ar keratoplasty for the treatment of keratoconus can improve the visual acuity significantly with less complications and low rejection rate, but the treatment of scarring stage keratoconus is mainly depends on the partial penetrating keratoplasty. OBJECTIVE: To evaluate the clinical efficacy of deep lamel ar keratoplasty for the treatment of scarring stage keratoconus. METHODS: Fifty-eight patients with Ⅲ and Ⅳ scarring stage keratoconus were divided into two groups:patients with corneal scarring in the superficial corneal stroma (n=37, superficial scar group), patients with corneal scarring in the deep or whole corneal stroma (n=21, deep scar group). The 58 patients who had accepted deep lamel ar keratoplasy were fol owed-up for 12 months and the changes of visual acuity before and after transplantation were compared. RESULTS AND CONCLUSION: Naked eye vision of al patients with deep lamel ar keratoplasy was significantly improved compared with that before transplantation, and 58 corneal grafts were al transparent. Only one patient had epithelial rejection after 2 months postoperative, and the corneal graft became transparent after a drug treatment. Two patients with deep keratoconus scars experienced glare after the transplantation in deep scar group, and they were switched to partial penetrating keratoplasty treatment. There was no significant difference of visual acuity at 1 year after transplantation between superficial scar group and deep scar group. Deep lamel ar corneal keratoplasty treatments can significantly improve the visual acuity of scarring stage keratoconus patients, while it is low in rejection rate with less complication. It is a safe, effective and feasible treatment method, especial y for the treatment of large base keratoconus.