散光环指导角膜移植术后选择性拆线的临床研究  

Selective suture removal directed by Placido disc to correct the astigmatism after penetrating keratoplasty

作　　者：高华[1] 王富华[1] 李岚[1] 陈敏[1] 史伟云[1] 

机构地区：[1]山东省眼科研究所暨眼科医院,青岛266071

出　　处：《中国实用眼科杂志》2004年第10期828-830,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的　介绍利用散光环指导角膜移植术后选择性拆线矫正散光的简易方法 ,探讨拆线时间、术前病因等对拆线后散光变化影响。方法　前瞻性研究。病例选择 :不同病因行穿透性角膜移植术后 7～ 15个月 3 5例 40只眼。拆线方法 :以电脑验光仪散光环的最大经线为直径画圆 (理想散光环 ) ,拆除散光环离理想散光环最远处对应的缝线。比较拆线前后视力、散光和不同因素对散光变化的影响。结果　平均随访时间 4个月。拆线前后平均裸眼和矫正视力分别提高 2 9和 3 3行。拆线前后平均散光分别为 7 3 6D和 4 3 5D (t =4 93 ,P =0 0 0 0 ) ,平均每拆线一根散光减少 1 5 1D ;术后 7～ 9、 10～ 12、 13～ 15个月拆线后平均散光变化分别为 4 88D、 2 16D、 2 15D ,7～ 9个月组同另两组差别有统计学意义 (F =13 72 ,P =0 0 0 0 ) ;圆锥角膜、感染性角膜炎、角膜变性三组拆线前后角膜散光变化分别为 2 5 5D、 1 68D、 1 82D ,圆锥角膜组同其他两组差别有统计学意义 (F =4 19,P =0 0 3 0 )。结论　散光环是指导角膜移植术后选择性拆线矫正散光的有效方法 ,拆线时间、术前病因等对拆线后散光变化有影响。Objective To introduce a simple method to direct selective suture removal with the help of placido disc to correct astigmatism,and study the effect of the time of suture removal and diffent etiology on the astigmatism changes after penetrating keratoplasty(PK).Methods A preceding study of 40 eyes(35 patients)with different etiology after PK.Postoperative evaluation included visual acuity,astigmatism and different etiology and so on.Results The average follow up time were 4 months.The average uncorrected vision was elevated 2.9 lines and the best corrected vision was elevated 3 3 lines postoperatively,the average astigmatism was 7 36D preoperatively,4 35D postoperatively(t=4 93, P =0 000).To remove one suture can decrease astigmatism 1 51D.Keratoconus produced extensive astigmatism compared to other diseases such as infectious keratitis,corneal degeneration.Conclusions To direct selective suture removal with placido disc is an effective method to correct astigmatism after PK.Different etiology and the time of suture removal had an effect on the efficacy of astigmatism.

关 键 词：拆线时间 散光 术后 角膜移植术 术前 圆锥角膜 病因 指导 变化 结论 

分 类 号：R778[医药卫生—眼科] R779.65[医药卫生—临床医学]