穿透性角膜移植术治疗单纯疱疹病毒性角膜炎的疗效分析  

Curative effect of penetrating keratoplasty for herpes simplex keratitis

作　　者：毕馨月[1] 陈敏[1] 谢立信[1] 

机构地区：[1]山东省眼科研究所,山东省青岛市266071

出　　处：《眼科新进展》2011年第4期338-340,共3页Recent Advances in Ophthalmology

基　　金：国家自然科学基金资助(编号:30901636)~~

摘　　要：目的观察并评价单纯疱疹病毒性角膜炎(herpes simplex keratitis,HSK)行穿透性角膜移植术(penetrating keratoplas-ty,PKP)的治疗效果。方法对74例(74眼)HSK患者行PKP后进行回顾性研究,观察术后视力、角膜内皮情况、免疫排斥及HSK复发的情况。结果患者术后视力恢复良好,术后18个月全部脱盲(最佳矫正视力>0.05),且术后24个月最佳矫正视力>0.5者占60.8%。角膜内皮细胞密度在术后6个月、12个月及24个月分别为(2325.7±516.6)mm-2、(2070.5±647.8)mm-2及(1825.9±630.3)mm-2;术后6个月、12个月、24个月角膜内皮细胞丢失率在有无出现免疫排斥患者间比较,差异均无统计学意义(P1=0.961,P2=0.305,P3=0.151),但出现免疫排斥患者的个体差异较大。术后24个月复发率及免疫排斥率分别为9.46%和28.38%。结论为避免PKP术后HSK复发及免疫排斥反应的发生,强调术后合理性、规范性及针对性的用药,特别是术后抗病毒药物的应用;重视术后随访,做到早发现、早诊断并及时干预治疗。此外,长时间户外日光照射也可能是诱发患者HSK复发的因素。Objective To evaluate the therapeutic effect of penetrating keratoplasty（PKP）for herpes simplex keratitis（HSK）. Methods Retrospective study was taken on 74 patients（74 eyes） who underwent PKP for HSK.Visual acuity,corneal endothelium,immune rejection and recurrence of HSK were observed after operation. Results Postoperative visual acuity went well.No patient was found with blindness with best corrected visual acuity more than 0.05.There was about 60.8% of patients with best corrected visual acuity more than 0.5 at postoperative 24 months.Endothelial cell densities were（2 325.7±516.6）mm-2,（2 070.5±647.8）mm-2 and（1 825.9±630.3）mm-2 at postoperative 6 months,12 months and 24 months.There was no statistical significance for postoperative cell loss between patients with graft rejection and non-graft rejection at postoperative 6 months,12 months and 24 months（P1=0.961,P2=0.305,P3=0.151）,but the difference of group with graft rejection was much higher.The recurrence rate and graft rejection rate were 9.46% and 28.38% at postoperative 24 months. Conclusions To obviate the recurrence and graft rejection,reasonable,normative and pertinence medicine treatment are emphasized,especially by using antiviral drug;Follow-up visit on time is also important,guarantee discovery,diagnose and treatment as early as possible.Also,Long outdoor sunlight shining is the possible motivation for induction.

关 键 词：单纯疱疹病毒性角膜炎 角膜移植 疗效分析 

分 类 号：R772.2[医药卫生—眼科]