圆锥角膜行板层角膜移植术和穿透性角膜移植术后屈光状态的比较  

Comparison of refractive function after lamellar keratoplasty and penetrating keratoplasty for keratoconus

作　　者：胥晓涵[1,2] 刘丽梅[2] 史伟云[2] 王婷[2] 

机构地区：[1]潍坊医学院,261061 [2]山东省眼科研究所山东省眼科医院

出　　处：《临床眼科杂志》2013年第1期5-8,共4页Journal of Clinical Ophthalmology

基　　金：国家自然科学基金(81200726);山东省自然科学基金青年基金(ZR2010HQ011)

摘　　要：目的探讨圆锥角膜行板层角膜移植术(LKP)和穿透性角膜移植术(PKP)术后屈光特征及变化趋势。方法对因圆锥角膜行LKP 30只眼与PKP 25只眼进行回顾性研究,通过比较两组术后不同时间点以及全拆线前后的最佳矫正视力(BCVA)、等效球镜(SE)、平均角膜曲率及角膜散光值,分析两种术式术后屈光状态的特征及变化趋势。结果 LKP与PKP术后BCVA均呈逐渐上升趋势,全拆线后LKP平均提高0.27±0.16,PKP为0.25±0.24;等效球镜向近视方向改变,全拆线前后比较LKP改变为(-2.29±4.58)D,PKP为(-6.24±2.71)D,两者之前有差异;平均角膜曲率逐渐增大,全拆线前后比较LKP增大4.11±2.94,PKP为5.71±2.53,两者之间无差异;角膜散光逐渐减小,全拆线前后比较LKP减小5.31±7.96,PKP为1.06+4.47,两者之间有差异。结论圆锥角膜行LKP和PKP两种术式相比,术后均BCVA逐渐上升,等效球镜向近视方向发展,平均角膜曲率增大而散光减小,但LKP较PKP拆线时间早,全拆线前后相比LKP角膜散光变化较大而PKP的等效球镜变化较大。Objective To study the characteristics and trends of refraction changes after lamellar kemtoplasty （LKP） and penetrating kemtoplasty （PKP）. Methods Medical records of 30 eyes that received LKP and 25 eyes that re- ceived PKP were reviewed. The characteristics and tendency of the refraction changes were analyzed by comparing best cor- rected visual acuity （ BCVA ）, spherical equivalent （ SE）, comenl curvature, and corneal astigmatism at different postoper- ative stages. The changes before and after stitch removal were also compared. Results BCVA increased gradually after both LKP and PKP. Mean increment before and after the stitch removal was 0.27 ＋ 0. 16 for LKP and 0.25 ~ 0. 24 for PKP. SE tended to develop a myopic shift, and the mean changes were significantly different between LKP （ -2.29 ~4.58 D） and PKP （ -6.24 ~2.71D）. Come~ curvature increased gradually, and mean increment before and after the stitch removal was 4. 11 ~2.94 for LKP and 5.71 ~2.53 for PKP, where there was no staKstical significance. Corneal astigma- tism decreased gradually, and its reduction after the stitch removal was 5.31 ~ 7.96 for LKP and 1.06 ＋ 4.47 for PKP （ P 〉0.05）. Conclusion BCVA increases gradually, SE tends to develop a myopic shift after both LKP and PKP. Mean- whiles postoperative come~ curvature increases while astigmatism decreases. However, the time of stitch removal for LKP is earlier than that for PKP, and LKP has larger change of corneal curvature whereas PKP has larger change of SE.

关 键 词：圆锥角膜 角膜移植术后 拆线 屈光 

分 类 号：R779.65[医药卫生—眼科]