单纯板层角膜切除术在治疗大泡性角膜病变中的应用  

Application of simple lamellar keratectomy in treatment of bullous keratopathy

作　　者：苏龙[1] 田芳[1] 孙靖[1] 张红[1] 

机构地区：[1]天津医科大学眼科中心,天津市300384

出　　处：《眼科新进展》2012年第10期969-971,共3页Recent Advances in Ophthalmology

摘　　要：目的探讨单纯板层角膜切除术治疗大泡性角膜病变的临床效果。方法回顾性分析2009年1月至2011年1月在我院接受单纯板层角膜切除术的大泡性角膜病变患者28例(28眼)的临床资料,所有患眼术前检查确认无恢复视功能希望,仅以改善症状为治疗目的。患眼接受深度仅达浅基质层,直径8.0mm范围的板层角膜切除术,术毕配戴角膜接触镜,1～2周摘镜。结果术中无一例患者出现并发症。术后角膜上皮自切除区边缘向中心生长,3～12d上皮全部覆盖,平均6.4d,摘除角膜接触镜后患者术眼角膜上皮完整,水肿不明显,且角膜透明度较术前好转,症状完全缓解,随访3～18个月,平均8.5个月,无一例复发需再次手术处理者。结论单纯板层角膜切除术治疗无恢复视功能希望的大泡性角膜病变,手术操作简单,术后效果满意,值得推广。Objective To evaluate the therapeutic effect of the simple lamellar keratoplasty for bullous keratectomy.Methods This was a retrospective and non-comparatable clinical study.Twenty-eight patients （28 eyes） with bullous keratopathy undergoing simple lamellar keratoplasty were recruited in this study from January 2009 to January 2011 in our hospital.The visual acuity of all patients was lost and preoperative confirmed,the aim of operation was to improve the symptoms. The excision scope of lamellar cornea only reached the shallow matrix layer with about 8 mm in diameter.The contact lens was covered when the operation was finished,and removed from postoperative 1week to 2 weeks.Results There was no any intraoperative complication.The corneal epithelium healed from the edge to the centre,the epithelium was whole covered from postoperative 3 days to 12 days（mean 6.4 days）.After the contact lens removed,the corneal epithelium was entire with no edema,the corneal transparency was better than pre-operation,the symptoms were all disappeared.The follow-up time was from 3 months to 18 months（mean 8.5 months）,there was no recurrence.Conclusion The simple lamellar keratectomy can effectively alleviate the symptoms of bullous keratopathy with simple operation and satisfied outcome,which is worthy of generalization.

关 键 词：板层角膜切除术 大泡性角膜病变 角膜上皮 

分 类 号：R772.2[医药卫生—眼科]