穿透性角膜移植术后低密度角膜内皮细胞白内障手术的临床观察  

Clinical observation of cataract extraction and intraocular lens implantation for cataract with low corneal endothelial cells density after penetrating keratoplasty

作　　者：谷晨[1,2] 王婷[1,2] 史伟云[1,2] 

机构地区：[1]山东省医学科学院山东省眼科研究所 [2]山东省眼科医院,济南250021

出　　处：《临床眼科杂志》2012年第1期16-19,共4页Journal of Clinical Ophthalmology

基　　金：山东省自然科学基金青年基金(ZR2010HQ011)

摘　　要：目的探讨穿透性角膜移植术(PKP)后角膜植片低内皮细胞密度的白内障患者行白内障摘除联合人工晶状体植入术的安全性。方法 PKP术后角膜内皮细胞计数<1500个/mm2行白内障摘除联合人工晶状体植入术治疗的患者15例(15只眼),根据晶状体核硬度分别选择不同的手术方式,行相应的围手术期处理,分别记录术前及术后3个月患者裸眼视力、角膜内皮细胞计数及裂隙灯观察角膜植片情况。结果术前内皮细胞计数为(1195±315)个/mm2,术后3个月内皮细胞计数为(1044±301)个/mm2,差异有统计学意义(P=0),内皮损失率为12.6%。术前及术后3个月的裸眼视力分别为0.06±0.09和0.35±0.22,两者差异有统计学意义,平均提高>5行标准视力表。白内障术后6个月之内无一例角膜内皮功能失代偿及角膜植片免疫排斥反应,角膜植片均保持透明。结论 PKP术后角膜植片内皮细胞计数<1500个/mm2的患者,只要注意围手术期治疗,选择合适的手术方法,和注意术中保护角膜内皮细胞,白内障摘除联合人工晶状体植入术是安全有效的。Objective To study the security of cataract extraction and intraocular lens（IOL） implantation for cataract with low corneal endothelial cells counts after penetrating keratoplasty.Methods 15 patients of cataract with low corneal endothelial cells density after penetrating keratoplasty（PKP） were treated with cataract extraction and intraocular lens implantation.Systemic and local steroid administration was given and method were chosen according to the cord of the lens.Visual acuity,central corneal endothelial cell density and the corneal graft before and after IOL implantation（3 months） and allograft rejection were recorded.Results Corneal endothelial cells density before IOL implantation was 1195±315个/mm2,after 3 months was 1044±301个/mm2,There was statistically significant difference between preoperative and postoperative results（P=0）,and the rate of endothelial cell loss was 12.6%.The visual before and after IOL implantation was 0.06±0.09 and 0.35±0.22,and the visual acuity after the operation was improved（5 lines）.The corneal grafts were transparent,no allograft rejection and no bullous keratopathy was found in 6 months after IOL implantation.Conclusion For the patients of cataract with low corneal endothelial cells density（1500个/mm2） after PKP,it is safe and effective to perform cataract extraction and IOL implantation when paying attention to the perioperative treatment and selecting the surgical methods.

关 键 词：角膜移植术 穿透性 超声乳化白内障吸除术 晶状体植入 内皮 角膜 

分 类 号：R779.66[医药卫生—眼科]