甘油冷冻保存角膜深板层移植治疗真菌性角膜溃疡的临床研究  

A clinical study:Treatment of fungal corneal ulcer with deep lamellar keratoplasty using glycerol cryopreserved corneas

作　　者：高洪瑞[1] 蒋华[1] 魏捷[1] 袁晔[1] 王光洁[1] 

机构地区：[1]第二军医大学济南临床医学院济南军区总医院眼科,山东济南250031

出　　处：《眼外伤职业眼病杂志》2009年第10期730-732,共3页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的探讨甘油冷冻保存的供体角膜行深板层角膜移植术治疗浅、中层真菌性角膜溃疡的手术适应证及临床效果。方法57例(57眼)经综合抗真菌措施治疗无效的浅、中层真菌性角膜溃疡施行深板层角膜移植术,随访8～24月,观察术后复发率、视力恢复、植片透明及并发症发生情况。结果57例中,52例治愈,成功率91.23%;5例复发,复发率8.77%。矫正视力0.1～0.2者20眼,0.3～0.5者24眼,>0.5者13眼。17例出现新生血管;13例发生排斥反应,均得到有效控制。植片全部透明。结论使用甘油冷冻保存的角膜供体行深板层角膜移植术既能及时去除病变组织,达到治疗目的,又有一定的增视效果,对药物治疗无效的浅、中层真菌性角膜溃疡是有效的手术方式。Objective To study the indication and clinical effects of deep lamellar keratoplasty （DLKP） using glycerol eryopreserved corneas for fungal corneal ulcer whose infected lesion lay in controlled by routine antifungal medicine. Methods 57 cases （57 eyes ） of fungal corneal ulcer who could not be controlled by routine antifungal medicine were treated with DLKP. All patients were followed up for 8 to 24 months after surgery. The recurrence rate, visual acuity, the transparency of grafts and surgical compli- cations were recorded. Results Among 57 cases of fungal corneal ulcer, 52 cases （91.23 %） were cured, 5 cases （8.77%） recurred; The corrected visual acuities of 20 eyes, 24 eyes and 13 eyes were 0.1 - 0.2,0.3 - 0.5, and more than 0.5, respectively ; 17 cases of neovascular and 13 cases of rejection after operation were effectively controlled;all corneal grafts were transparent. Conclusion DLKP can not only remove fungal infection tissue to attain to cures purpose, but also enhance the visual acuity to some extent,it is one of the effective operation for fungal corneal ulcer whose infected lesion lies in the superficial or middle layer and could not be controlled by routine antifungal medicine.

关 键 词：角膜 冷冻保存 深板层角膜移植 真菌 角膜溃疡 

分 类 号：R779.65[医药卫生—眼科]