板层角膜移植术治疗角膜边缘变性的临床疗效观察  

Clinical curative effect of corneal marginal degeneration treated with lamellar keratoplasty

作　　者：曹婷[1] 杨燕宁[1] 袁静[1] 邢怡桥[1] 艾明[1] 余桂香[1] 

机构地区：[1]武汉大学人民医院眼科,湖北省武汉市430060

出　　处：《眼科新进展》2010年第3期247-249,共3页Recent Advances in Ophthalmology

摘　　要：目的观察板层角膜移植术对角膜边缘变性的治疗效果。方法选取2002年至2008年我院收治的Terrien角膜边缘变性患者17例(28眼)进行板层角膜移植术,年龄20～63岁,病史3～20a。其中双眼发病11例,单眼发病6例;角膜穿孔13眼。对未发生角膜穿孔的15眼进行手术前后角膜地形图检查。手术方法:根据病变的范围,采用甘油保存的角膜材料作板层角膜移植。术后随访6个月～6a。结果28眼术后植片平整光滑,均恢复病变区角膜正常厚度,病变区得到有效控制,均无复发。术后21眼(75%)视力提高,7眼(25%)视力无明显变化。角膜地形图检查显示术后角膜散光度及角膜曲率均较术前有所下降,差异均具有显著统计学意义(均为P=0.00)。结论采用甘油保存角膜材料行板层角膜移植术可以有效控制角膜边缘变性的病情发展,预防及修补角膜穿孔,重建角膜的正常厚度和曲率、减少散光且远期疗效稳定,是治疗Terrien角膜边缘变性安全有效的方法。Objective To observe the clinical curative effect of lamellar keratoplasty on corneal marginal degeneration.Methods From the year 2002 to 2008,17 patients（28 eyes） with Terrien corneal marginal degeneration in our hospital underwent lamellar keratoplasty,the age of patients was from 20 years old to 63 years old,and the case history was from 3 years to 20 years.Both eyes affected were 11 cases,and 13 eyes with corneal perforation were included.Corneal topography examination was undertaken in 15 eyes with no corneal perforation before and after the operation.According to the affection range,the preserved corneal stuff in glycerine was used in lamellar keratoplasty as the operation method.The follow-up time was from 6 months to 6 years.Results The graft were slick and the corneal thickness of the affection range were recovered to normal in all cases,the affection range was controlled effectively and had no recurrence.Visual acuity in 21 eyes（75%） improved and 7 eyes（25%） didn＇t have marked change after operation.Corneal topography examination showed the corneal astigmatism and curvature after operation were reduced compared with that before operation,there were statistical differences（all P〈0.01）.Conclusions Lamellar keratoplasty with preserved corneal stuff in glycerine can effectively control the progression of corneal marginal degeneration,prevent and mend the corneal perforation,reestablish the normal corneal thickness and curvature,reduce the corneal astigmatism with stable long curative effect,is an effective and safe way on Terrien corneal marginal degeneration.

关 键 词：角膜边缘变性 保存角膜材料 板层角膜移植 

分 类 号：R772.2[医药卫生—眼科]