带环形板层巩膜瓣全板层角膜移植术治疗严重眼部化学伤临床及免疫学探讨  

Clinical and immunological studies on transplantation of total lamellar cornea with circular lamellar sclera on treating serious chemical burn of eye

作　　者：伍桂军 丁伟 杨方耀 刘迎庆 刘晓环 

机构地区：[1]第一军医大学第一附属医院眼科,510515

出　　处：《中国实用眼科杂志》2000年第12期768-770,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的 :观察带环形板层巩膜瓣全板层角膜移植术治疗严重眼部化学伤的临床疗效 ,探讨其免疫学机制。方法 :对 148例 (148眼 )行角膜移植术的患者进行回顾性分析 ,将 42例 (4 2眼 )行带环形板层巩膜瓣全板层角膜移植术治疗的严重眼部化学伤 ( 组 )与同期 13例 (13眼 )行全角膜移植术 ( 组 )和 93例 (93眼 )行部分穿透性角膜移植术 ( 组 )的患者进行对照 ,比较手术后角膜的透明度、新生血管出现的时间、排斥率及排斥反应出现的时间。结果 :带环行板层巩膜瓣全板层角膜移植组与全角膜移植组比较 ,角膜植片新生血管出现的时间及排斥反应出现的时间均延迟 ,排斥率下降 ,透明率明显提高。而较部分穿透性角膜移植术组半年后的排斥率明显增加 ,透明率明显下降。结论 :带环形板层巩膜瓣全板层角膜移植术是严重眼部化学伤后重建眼前节的有效方法 ,其免疫学机制复杂。术后维持泪膜的质量。To observe the clinical results of total lamellar cornea with circular lamellar sclera transplantation to treat serious chemical burn of eye and study its immunological mechanisms.Methods:The patients(148 cases,148eyes)with corneal transplantation were retrospectively analyzed,I group(42 cases,42 eyes)is the patients with serious chemical burn of eye transplantation of total lamellar cornea with circular lamellar sclera,Ⅱ group(13 cases,13 eyes)is the patients transplantation of total cornea corresponding period of the Ⅰ group,Ⅲ group(93 cases,93 eyes)is the patients with the partial penetrating keratoplasty corresponding period of the I group too.The time of tear film break up their rate of rejection and the time of occurrence of corneal neovascularization were compared.Results:The time of occurrence of corneal neovascularization and rejection of I group were later than Ⅱ group,but the rate of rejection after 6 months operation was obviously increased in comparison with the Ⅲ group.Conclusion:Total lamellar cornea with circular lamellar sclera transplantation is an important method for treating serious chemical burn of eye,its immunological mechanisms is complexity.Its important to increase the result of operation keeping high standard in quality of tear film and using high effective immunosuppressive drug after operation.

关 键 词：角膜移植 化学伤 免疫 

分 类 号：R779.130.5[医药卫生—眼科] R779.65[医药卫生—临床医学]