个性化治疗角膜穿孔的临床观察  

Clinical observation on the individuated treatments of corneal perforation

作　　者：徐旭[1] 高明宏[1] 肖卉[1] 禹海[1] 周润海[1] 

机构地区：[1]沈阳军区总医院眼科,中国辽宁省沈阳市110016

出　　处：《国际眼科杂志》2009年第9期1755-1757,共3页International Eye Science

摘　　要：目的:探讨应用不同手术方法治疗角膜穿孔的适应证及疗效。方法:采用非随机回顾性系列病例研究,选择2005-10/2007-08在沈阳军区总医院住院的20例20眼角膜穿孔患者,分别选择穿透性角膜移植术(6例,30%)、眼前节重建术(4例,20%)、板层角膜移植术(6例,30%)、羊膜移植术(4例,20%),术后随访6～30mo,观察患者穿孔愈合情况、术后视力、角膜植片透明度及并发症。结果:所有病例均在手术后封闭穿孔。术后增视者有16眼,手术增视率为80%;穿透性角膜移植者植片7例透明,1例半透明,1例混浊。眼前节重建术植片半透明或混浊(Ⅱ期行新鲜角膜移植)。板层角膜移植术3例透明,3例混浊。并发症:虹膜粘连4例;继发性青光眼3例;排斥反应2例;原病复发1例;双前房1例。结论:根据角膜穿孔的原因、位置、大小等综合因素,对角膜穿孔患者灵活选用不同手术方法,能够达到保存眼球完整性、增进视力的要求。AIM：To explore the indication and efficacy of different types of surgery for corneal perforation.·METHODS：In our nonrandomized retrospective case series,twenty cases（20 eyes） with corneal perforation at the general hospital of shenyang military command between October 2005 and August 2007 underwent penetrationg keratoplasty（six cases） ,anterior segment reconstruction（four cases） ,lamellar keratoplasty（six cases） ,aminiotic membrane transplantation（four cases） . Postoperative visual acuity,corneal graft clarity and compli-cations were studied during a follow-up of 6 to 30 months.·RESULTS：ALL perforation was closed,postoperative visual acuity was improved in 16 cases（80%） . Seven grafts of penetrationg keratoplasty were transparent,one was semi-transparent,one was cloudy. Four grafts receiving anterior segment reconstruction were cloudy（received secondary PKP） . Three grafts of lamellar keratoplasty were transparent,three was cloudy. The complications inclued iris synechia in 4 eyes,secondary glaucoma in 3 eyes,graft rejection in 2 eyes,recurrence of the primary diseases in 1 eye,double chamber in 1 eye.·CONCLUSION：In patients with corneal perforation,operation should be done according to the intial causes and the size of corneal perforation. It is an effective approach for preservation of eyeballs and restoration of visual function.

关 键 词：角膜疾病 角膜移植 羊膜 手术后并发症 

分 类 号：R779.6[医药卫生—眼科]