大气泡辅助下的深板层角膜移植术治疗角膜后弹力层膨出  

Big bubble assisted deep anterior lamellar keratoplasty for the treatment of descemetocele

作　　者：王旭[1] 高芯 王巧玲[1] 党惠 位宁[1] 丁刚[1] 张晨明[1] Wang Xu;Gao Xin;Wang Qiaoling;Dang Hui;Wei Ning;Ding Gang;Zhang Chenming(Department of Ophthalmology,Ji'nan Second People's Hospital,Ji'nan 250001,China)

机构地区：[1]济南市第二人民医院眼科,250001

出　　处：《中华眼外伤职业眼病杂志》2019年第1期20-24,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的评价大气泡辅助下的深板层角膜移植术治疗角膜后弹力层膨出的效果。方法回顾性分析2017年6月至2017年10月本院角膜后弹力层膨出7例(7眼)的临床资料,利用组织工程角膜行大气泡辅助下的深板层角膜移植术治疗,术后随访6个月。结果所有患者均成功保住了眼球,未发生角膜穿孔或术后双前房。术后14d,眼前段OCT检查显示所有植片的角膜基质均未出现水肿。术后6个月,6眼的裸眼视力达到0.1~0.3。1眼植片全角膜血管化,裸眼视力为眼前手动。随访期间,均无复发。所有患者术后都未出现内皮型排斥反应、继发性青光眼或白内障。4眼出现轻度上皮型免疫排斥,经过抗排斥治疗植片均恢复透明。1眼术后出现一过性高眼压,经过药物治疗1周后眼压恢复正常。结论利用组织工程角膜行大气泡辅助下的深板层角膜移植术治疗角膜后弹力层膨出的效果良好。Objective To evaluate the efficacy of deep anterior lamellar keratoplasty (DALK) assisted with big bubbles for the treatment of descemetocele.Methods The data of 7 eyes of 7 cases with descemetocele from Jun.2017 to Oct.2017 underwent DALK assisted with big bubbles with tissue-engineered cornea were analyzed retrospectively.The followed-up time was 6 months.Results All patients were managed to keep their eyeballs.There was no corneal perforation or descemet membrane detachment after DALK.At 14 days after surgery,no edema in the corneal stroma of all tissue engineering cornea occurred with the SL-OCT examination.At 6 months after surgery,the uncorrected visual acuity was 0.1-0.3 in 6 eyes.The whole corneal neovascularization was observed in 1 eye,whose uncorrected visual acuity was HM.During follow-up,no recurrence occurred.No endothelial rejection,secondary glaucoma or cataract occurred.Mild epithelial immune rejection occurred in 4 eyes,and the grafts were restored to be transparent after antirejection treatment.One eye suffered temporary high IOP.The IOP returned to normal after medicine treatment.Conclusion DALK assisted with big bubble with tissue-engineered cornea is an effective method for the treatment of descemetocele.

关 键 词：角膜移植术 深板层 大气泡辅助 组织工程角膜 后弹力层膨出 

分 类 号：R779.6[医药卫生—眼科]