前房注气联合周边虹膜切除术治疗深板层角膜移植中微穿孔的疗效观察  

Gas infusion anterior chamber combinated with peripheral iridectomy treatment for the complications caused by micro-perforation in deep lamellar keratoplasty

作　　者：吴彦超[1] 刘延东[1] 王东[1] 肖丽[1] 鲁韶音[1] 

机构地区：[1]邢台市眼科医院眼科,邢台054001

出　　处：《中国实用眼科杂志》2009年第4期395-398,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的观察前房注气联合周边虹膜切除术，在预防和治疗深板层角膜移植术中，微穿孔所引起并发症的临床效果。方法总结自2006年3月至2008年1月在邢台眼科医院行深板层角膜移植术病人38例（38只眼），病例全部为圆锥角膜，且术中全部中出现后弹力层微穿孔（未穿孔和穿孔较大的病例均未包括在研究中），将38例病例分为两组（Ⅰ组11例，Ⅱ组27例），Ⅰ组的病人在术中行前房注气术，Ⅱ组的病人在术中行前房注气联合周边虹膜切除术，术后观察角膜植片的层问积液、积气、气体位置和眼压，并采取多种措施进行处理。结果在Ⅰ组患者中：层间积液的患者有8例，占72．73％；眼压增高的患者有5例，占其中的54．55％；前房注气＋周边虹膜切除术处理成功4例，成功率为100％，在Ⅱ组患者中，27例病人均未出现层间积液和眼压增高。结论微穿孔引起的层间积液是深板层角膜移植术的常见并发症，而前房注气联合周边虹膜切除术是预防和治疗层间积液的较好方法。Objective To observe the clinical results in the prevention and treatment of complications caused by micro-perforation in deep lamellar keratoplasty（DLKP）by gas infusion anterior chamber combinated with peripheral iridectomy.Methods Aggregated 38 deep lamellar keratoplasty cases （38 eyes）since March 2006 to January 2008 in Xingtai Eye Hospital, all cases were keratoconus, and all appeared micro-perforation of lamina elastica posterior （No mic-perforation and larger-perforation cases were not included in this study）, 38 cases were divided into two groups（Group 1 had 11 cases, Group 2 had 27 cases）, 11 cases of group 1 were performed gas infusion anterior chamber,and 27 cases of the group 2 were performed gas infusion anterior chamber combinated with peripheral iridectomy, we observed the interlamellar dorpsy and pneumatosis, location of gas, and intraocular pressure, and took various measures to deal with.Results Patients in Group 1 ： 8 cases had interlamellar dorpsy, accounted for 72.73%;5 cases had oculi hypertonia,accounded for 54.55%;4 cases successed by gas infusion anterior chamber combinated with peripheral iridectomy former, and the successful rate was 100%.In Group 2 ： 27 cases had no interlamellar dorpsy and oculi hypertonia.Conclusion Interlamellar dorpsy caused by micro-perforation was a common complication in deep lamellar keratoplasty, and the gas infusion anterior chamber combinated with peripheral iridectomy was a better prevention and treatment for the Interlamellar dorpsy.

关 键 词：深板层角膜移植术 微穿孔 层间积液 

分 类 号：R779.12[医药卫生—眼科] R775.205[医药卫生—临床医学]