儿童穿透性角膜移植术  

Penetrating keratoplasty in children

作　　者：徐锦春[1] 谷树 严贾卉 刘景祥[1] 张瑞雪[1] 

机构地区：[1]白求恩医科大学第三临床学院眼科

出　　处：《眼科研究》1998年第3期220-221,共2页Chinese Ophthalmic Research

摘　　要：目的评价儿童角膜移植术的意义及如何提高手术成功率。方法对３～１４岁儿童角膜炎及机械性损伤致角膜瘢痕性混浊合并白内障、无晶状体眼，先天性角膜混浊及角膜溃疡、穿孔、脓肿等４０例（４２眼），行穿透性角膜移植联合白内障摘除、人工晶状体植入术。术后随访０．７～７．５ａ。结果植片总透明率７３．８％，其中角膜炎症及机械性损伤致瘢痕性混浊者为８１．３％。视力提高率６４．３％，脱盲率４７．６％，脱残率２８．６％。排斥反应发生率２８．６％。结论儿童期角膜移植术有重要的临床意义和社会意义。手术在视功能发育前进行尤为重要。儿童眼球解剖生理特点、术后护理及检查治疗上的困难，是穿透性角膜移植术较成人难度大、成功率低的重要原因，故应在供体选择、手术技巧及术后处理。ObjectiveTo evaluate the issues invoved in treatment of pediatric keratoplasty and how to improve operative success.MethodsThree combined surgery (penetrating keratoplasty,cataract extraction,implantation of intraocular lens) was performed on 40 children (42 eyes) between 3 and 14 years old with keratitis,and corneal cicatricial opacity,cataract and aphakic eye caused by mechanical trauma,congenital corneal opacity,corneal ulcer,perforation and abscess.Postoperative follow up was 0.7～7.5 a.ResultsThe rate of graft transparency was 73.8%,including 81.3% patients with cicatricial opacity caused by mechanical trauma.64.3% showed improvement in vision to different degrees,47.6% were no longer blind,and 28.6% got rid of deformity.The rate of rejection was 28.6%.ConclusionChildhood keratoplasty is of clinical and social significance.It is very important that operation is performed before complete development of visual function.In comparision with adults treatment,pediatric penetrating keratoplasty is more difficult and has a lower success rate.The main causes are anatomical and physiological characteristics of the pediatric eye,and difficulties in postoperative nursing,examination and treatment.Donor selection,operative skill,postoperative management and careful follow up are all important for a good outcome.

关 键 词：儿童 穿透性角膜移植术 

分 类 号：R779.65[医药卫生—眼科]