双泡技术在深板层角膜移植手术中的应用  

Double bubble technique in deep lamellar keratoplasty surgery

作　　者：高明宏[1] 陈颖欣[1] 

机构地区：[1]沈阳军区总医院眼科,沈阳110016

出　　处：《中国实用眼科杂志》2011年第12期1226-1228,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的 评价双气泡技术在深板层角膜移植手术中应用的有效性。方法对35例（37只眼）内皮功能正常的角膜基质病变病人，采用以前房内小气泡引导基质内注入大气泡成功分离后弹力膜的双泡技术进行深板层角膜移植术，分析手术技巧，观察术后最佳矫正视力及并发症。结果30只眼（81．1％）采用双泡技术成功完成后弹力膜分离；5只眼（13．5％）术中发生后弹力膜微穿孔，继续完成手术；2只眼（5．4％）因后弹力膜穿孔范围较大而改行穿透性角膜移植术。随访6-18（平均12．3）个月，术后平均最佳矫正视力为0．47±0．17（0．1～0．8）。术后并发症：4只眼（10．8％）假前房（层间分离），经前房内注入空气泡顶压后治愈；3只眼（8．1％）激素相关性眼压升高；4只眼（10．8％）排斥反应，均经相应的药物治疗治愈。结论双泡技术能显著提高角膜后弹力膜完全分离的成功率，并能缩短手术时间，提高手术质量，是深板层角膜移植手术技巧中较为安全有效的一种技术。Objective To evaluate the effectiveness of double-bubble technique in deep lamellar keratoplasty. Methods Small air bubbles were injected into anterior chamber for a guide before injection of large air bubbles within the matrix to separate Descemet＇s membrane in 35 patients （37 eyes） of normal endothelial function with corneal diseases. Then, the best corrected visual acuity and complications were observed, and the surgical techniques were analyzed at last. Results The Descemet＇s membrane of 30 eyes （81.1%） were successfully separated by double-bubble technique, 5 eyes （13.5%） were also achieved success with microperforation of the Descemet＇s membrane, 2 eyes （5.4%） were di- verted to penetrating keratoplasty due to large range of perforation of the Descemet＇s membrane. The mean postoperative best corrected visual acuity was 0.47±0.17 （0.1-0.8） in follow-up of 6 to 18 （mean 12.3） months. The false anterior chamber （layer separation） of 4 eyes （10.8%） were cured by injection of air bubbles to the appropriate pressure, 3 eyes （8.1%） of hormone-related elevation of intraocular pressure and 4 eyes （10.8%） of immune rejection were all cured by drug treatment. Conclusions Double-bubble technique can significantly improve the success rate of corneal Descemet＇s membrane separation and can shorten the operative time and improve the quality of operation. Double-bubble technique is a kind of safe and effective surgical technique on deep lamellar keratoplasty.

关 键 词：双气泡技术 角膜移植 后弹力膜 

分 类 号：R779.12[医药卫生—眼科]