飞秒激光辅助的深板层角膜移植术治疗圆锥角膜及角膜扩张症  

Femtosecond laser-assisted deep anterior lamellar keratoplasty for keratoconus and keratectasia

作　　者：陆燕[1] 杨丽萍[1] 葛轶睿[1] 薛春燕[1] 陈祥菲[1] 王春红[1] 黄振平[1] 

机构地区：[1]南京军区南京总医院眼科,江苏省南京市210002

出　　处：《眼科新进展》2013年第10期942-945,共4页Recent Advances in Ophthalmology

基　　金：国家自然科学基金面上项目(编号:81270979);江苏省自然科学基金面上项目(编号:BK2012777)~~

摘　　要：目的 评价飞秒激光辅助的深板层角膜移植术治疗圆锥角膜及角膜扩张症患者的临床效果及安全性。方法9例10眼患者（8眼为圆锥角膜，2眼为LASlK术后角膜扩张症）采用飞秒激光辅助进行深板层角膜移植手术。术前超声测量角膜厚度为319．00～454．00（393．90±49．85）μm，术前裸眼视力：0．01～0．20（0．09±0．07），术前最佳矫正视力：0．12-～1．00（0．40±0．30），供体及受体角膜均采用飞秒激光进行切削，供体角膜直径比受体直径大0．2mm，供体直径为7．30～8．00（7．73±0．21）mm，供体切割厚度为300．00—510．00（399．00±55．27）μm，所有患者术后随访1．50～13．00（7．65±4．28）个月。结果术后早期所有角膜植片透明。1例患者术中出现后弹力层微穿孔。角膜厚度为389．00～598．00（483．40±53．70）μm，角膜地形图恢复正常形态。术后最后一次随访裸眼视力为0．10～0．60（0．25±0．17），最佳矫正视力为0．20～1．00（0．49±0．25）。随访（7．65±4．28）个月，患者角膜内皮细胞丢失率为4．6％。结论飞秒激光辅助的深板层角膜移植对于圆锥角膜及角膜扩张症患者来说具有良好的临床效果及安全性。Objective To evaluate clinical effects and safety of femtosecond la- ser-assisted deep anterior lamellar keratoplasty for keratoconus and keratectasia. Methods Ten eyes （8 keratoconus and 2 keratectasia） from 9 patients were conduc- ted deep anterior lamellar keratoplasty assisted by femtosecond laser. Before the surger- y, corneal thickness was 319 - 454 （ 393.90 ± 49.85 ） μm measured by ultrasound; Naked vision was 0. 01 -0.20 （0. 09 ±0.07） ;best corrected visual acuity was 0. 12 - 1.00 （0.40 ± 0.30）. Cornea from donors and receptors were cut by femtosecond laser. Cor- neal diameters of donors were 7.3 - 8.0 （7.73 ± 0.21 ） mm,0.2 mm larger than those of receptors. The corneal cutting thickness of donors was 300 - 510 （399.00 ± 55.27 ）μm and all the patients were followed up for 1.5 - 13.0 （ 7.55 ±4.28 ） months. Results All the corneal grafts were transparent early postoperation. Corneal descemet membrane of 1 patient was slightly perforated in the surgery. Corneal thickness was 389 -598 （483.40±53.70） μm and corneal topography restored to the normal appearance. Pa- tients＇ naked vision was 0.1 -0.5 （0.25 ±0.17） ,best corrected visual acuity was 0.2 - 1.0 （0.49 ± 0.25 ） in the last follow up after surgery. Corneal endothelial cell loss rate was 4.5% after （7.55 ± 4.28 ） months follow up. Conclusion Femtosecond laser-as- sisted deep anterior lamellar keratoplasty has good clinical effects and high safety to pa- tients with keratoconus and keratectasia.

关 键 词：飞秒激光 深板层角膜移植 圆锥角膜 角膜扩张症 

分 类 号：R779.12[医药卫生—眼科]