波士顿Ⅰ型人工角膜移植治疗眼部严重陈旧化学伤和热烧伤12例分析  

Boston TypeⅠKeratoprosthesis in Obsolete Severe Chemical and Thermal Eye Burn

作　　者：高明宏[1] 陈颖欣[1] 徐旭[1] 于静[1] 禹海[1] 周润海[1] 杜春光[1] 姚颖[1] 王颖[1] Michael Wellington Belin 王明武[2] 

机构地区：[1]沈阳军区总医院眼科,辽宁沈阳110016 [2]美国亚利桑那大学眼科,tucsonazusa85721

出　　处：《创伤与急危重病医学》2013年第1期54-57,共4页Trauma and Critical Care Medicine

基　　金：辽宁省自然科学基金(20102252)

摘　　要：目的探讨人工角膜移植术治疗眼部严重陈旧性化学伤和热烧伤的临床疗效。方法对2010年7月～2013年7月12例(12眼)陈旧性眼部烧伤病(酸烧伤、碱烧伤和热烧伤各4例)进行了波士顿Ⅰ型人工角膜移植术。手术方法包括无晶体眼人工角膜植入术和人工晶体眼人工角膜植入术。术后随访时间1～3年,平均2.2年。结果最后一次随访,所有病例人工角膜均与植床愈合良好,无渗漏和脱离。最佳矫正视力4例0.25;1例0.4;4例0.6;2例0.8;1例1.0。正视(不接受镜片)2例;远视(+1.0～+3.5 D)3例;近视(-1.0～-3.5 D)7例。视野30～110度,平均85度。术后并发症包括人工角膜后膜(镜后膜)6例,后发性白内障2例,均经过钇铝石榴石(YAG)激光膜切开术治愈;玻璃体出血5例,经药物治疗治愈;眼压升高4例,3眼停用激素性眼液后恢复正常,另1眼依赖药物控制。结论波士顿Ⅰ型人工角膜移植术是治疗眼部陈旧性化学伤和热烧伤的有效治疗方法。Objective To investigate the efficacy of Boston typeⅠkeratoprosthesis in treatment of obsolete severe ocular chemical and thermal burn.Methods Boston type Ⅰ keratoprosthesis keratoplasties including pseudophakic and phakic implantation were performed in 12 cases(12 eyes) of obsolete severe ocular chemical and thermal burn from July 2010 to July 2013.The postoperative follow-up period was 1 to 3 years(2.2 years in average).Results The keratoprostheses in all cases had healed with the corneal grafts without leakage and dislocation.The best corrected visual acuities were 0.25 in 4 eyes,0.4 in 1 eye,0.6 in 4 eyes,0.8 in 2 eyes and 1.0 in 1 eye.Emmetropia in 2 eyes,hyperopia(+ 1.0 ～ + 3.5) in 3 eyes and myopia(- 1.0 ～- 3.5) in 7 eyes.Visual field 30° ～ 110°(85°in average).The postoperative complications included retrokeratoposthesis membranes in 6 eyes and after catatacts in 2 eyes,which were cured by YAG laser capsulotomy; vitreous hemorrhage in 5 eyes treated by medication; secondary glaucoma in 4 eyes,of which,the intraocular pressure became normal in 3 eyes when steroids eye drops were stopped to use,while the antiglaucoma drugs has to be continuously used in 1 eye.Conclusion Boston typeⅠkeratoprosthesis is an effective surgical treatment in obsolete severe ocular chemical and thermal burn.

关 键 词：波士顿Ⅰ型人工角膜 陈旧化学伤 热烧伤 角膜移植 

分 类 号：R779.65[医药卫生—眼科]