玻璃体视网膜手术联合穿透性角膜移植手术临床观察  

Outcome of Combined Penetrating Keratoplasty with Vitreoretinal surgery

作　　者：王丽强[1] 黄一飞[1] 尹东芳[1] 钱海燕[1] 

机构地区：[1]解放军总医院眼科,北京100853

出　　处：《中国伤残医学》2006年第2期21-23,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的：观察在应用人工角膜下行玻璃体视网膜手术联合穿透性角膜移植手术患者的手术适应症以及临床疗效，探讨影响手术成功的因素。方法：回顾总结我院18例从1996年12月至2005年6月行玻璃体视网膜手术联合穿透性角膜移植病人，分析病因，手术适应症，前后节功能恢复以及和手术并发症等因素。结果：13眼视力较前提高，其中视力在0．05-0．1之间者5只眼：0．1～0．3者4眼，0．5者1眼；视力与术前无变化者5眼，10只眼角膜植片透明，2只眼再次做角膜移植手术，6只眼出现角膜植片水肿、混浊，其中3眼为角膜排斥反应，3眼为角膜内皮失代偿。结论：尽管联合手术的视功能恢复是有限的，但为患者脱盲做出了贡献。Objective： To assess the effectiveness of a combined procedure （pars plana vitrectomy with temporary keratoprosthesis, vitreoretinal surgery, and penetrating keratoplasty） and probe determine, factors influenceon corneal transplant success rates. Methods： Records for 18 patients who underwent penetrating keratoplasty in combination with vitreoretinal surgery between 1996 and 2005, with follow-up from 3 months to 9 years, were evaluated retrospectively. Analysis was focused on ocular history, functional and anatomic anterior and posterior segment outcome, and complications. Results： 18 eyes had light perception or VA of hand motions only. The best-corrected VA improved during the first 3 months, increased in 72.2% of all eyes, remained unchanged in 27.78%, and no decreased. In 3 of 18 eyes （16.67%）, VA was better than finger counting and hand motions, and nine eyes（50 %）showed useful vision （0.05） postoperatively. 10 eyes showed a clear corneal graft （55.56%）. 2 eyes needs the second keratoplasty, Bullous corneal edema was evident in 3 eyes, band keratopathy was evident in a 3 eyes. 10 patients were observed for more than 2 years; 6 had a clear graft （60%）. Two eyes （11.11%） had silicone oil--corneal endothelium contact and all of these grafts failed. Conclusion： Although the functional outcome of a combined procedure is limited by primary and secondary tissue destruction, preserving ambulatory vision is possible and thus improves the quality of life, at least in patients with single remaining eyes.

关 键 词：玻璃体切除 角膜 移植 临时人工角膜 

分 类 号：R779.65[医药卫生—眼科]