深板层角膜移植术治疗角膜疾病  

Deep Lamellar Keratoplasty in the Treatment of Cornea Disease

作　　者：杨丽霞[1] 余鹰翔[1] 陈国苍[1] 郑祥榕[1] 林建[1] 高朋芬[1] 

机构地区：[1]福州总医院眼科

出　　处：《福州总医院学报》2010年第3期143-145,共3页Journal of Fuzhou General Hospital

摘　　要：目的:探讨深板层角膜移植术治疗角膜疾病的临床应用效果及手术适应症。方法:总结2001年以来行深板层角膜移植术的患者共42眼,其中蚕蚀性角膜溃疡13眼,单疱病毒性角膜炎后深层角膜斑翳4眼,真菌性角膜溃疡5眼,细菌性角膜溃疡1眼,角膜带状变性6眼,斑块状角膜营养不良4眼,角膜热烧伤6眼,角膜化学伤3眼。术后予以糖皮质激素眼液+1%环胞霉素A眼液滴眼。同时观察视力、角膜植片及术后并发症的情况。结果:40眼角膜植片愈合良好,创面光滑,逐渐恢复透明。1眼因外伤致角膜上皮缺损延期愈合;1眼因真菌性角膜溃疡复发改行全角膜移植术,其余眼表保持稳定,平均随诊43.8个月,视力均有不同程度提高。除角膜层间新生血管及上皮型排斥反应外,未出现明显基质型排斥反应。结论:近年来深板层角膜移植术发展迅速。它是一种成份角膜移植术,不但能获得与穿透角膜移植相似的透明性和视力恢复效果,还可减少术后内皮型排斥反应的发生及眼内手术并发症的危险,达到治疗和增视的双重目的。但对角膜内皮细胞的形态和数量很难做出正确的评价的患眼应选择穿透性角膜移植术。Objective： To discuss the clinical effect and indication of deep lameUar keratoplasty （DLKP） in the treatment of cornea disease. Method： we reviewed the 42 eyes treated by DLKP since 2C01 in Fuzhou General Hospital. The patients included 13 eyes of Mooren ulcer, 4 eyes of virulence corneal maeula, 5 eyes of fungal corneal ulcer, 1 eye of bacteria corneal ulcer, 6 eyes of band shaped corneal degeneration, 4 eyes of macular corneal dystrophy, 6 eyes of corneal heat burn and 3 eyes of corneal chemical burn. Glucocorticosteroid and 1% cyelosporin A eyedrops were used after operation. The visual acuity, allograft and complication after the operation were observed. Results： During the 43.8 months of average follow - up time, corneal epithelium of 1 eye was delayed healed because of injury, 1 eye was treaded by sclerkeratoplesty with ftmgal infection recurred, the other 40 eyes were well recovered with transparent cornea graft and improved visual acuity. No stroma rejection but lamellar neovaseularization and epithelium rejection was found. Conclusion： As compared with penetrating keratoplasty （PKP）, DLKP offers the similar effeet for recovery of corneal clarity and vision acuity but less endothelium rejection and complication in patiants. To those eyes with keratolimbus severely destroyed, large diameter DLKP with fresh limbal stem cell is recommended to reconstruct ocular surface and restore norreal structure and thickness of cornea. PKP is recommended to those eyes with the form and quantity of corneal endothelium difficult to be estimated.

关 键 词：深板层 角膜移植 角膜病 

分 类 号：R779.12[医药卫生—眼科]