板层角膜移植术治疗角膜穿孔伤合并角膜缺损的临床效果  

Clinical effect of lamellar keratoplasty for corneal perforating injuries with corneal defects

作　　者：陈书扬[1] 邝国平[1] 彭正武[1] 朱俊东[1] 李盛国[1] 周小平[1] 向群[1] 

机构地区：[1]郴州市第一人民医院眼科,湖南423000

出　　处：《中华眼外伤职业眼病杂志》2016年第4期267-269,共3页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的评价板层角膜移植术治疗角膜穿孔伤合并角膜缺损的临床效果。方法将54例（54眼）角膜穿孔伤合并角膜缺损者随机分成两组：观察组21例，施行板层角膜移植术治疗；对照组33例，施行常规角膜清创缝合术治疗。术后随访3个月观察其视力、角膜散光及眼压。结果随访期末观察组角膜透明、厚度正常，无角膜斑翳，无移植排斥反应或术后高眼压。视力0．1～0．3者15眼，0．4—0．5者2眼。视力提高17眼，占80．95％；而对照组视力0．08—0．3者14眼，0．4—0．5者2眼。视力提高者16眼，占48．48％。两组视力提高的比例差异有统计学意义（Х^2=5．69P=0．017）。观察组术眼平均散光（-1．50±0．25）D，对照组术眼平均散光（-4．50±0．75）D，差异具有统计学意义（t=17．66P=0．013）。术后两组术眼眼压均正常。结论板层角膜移植术是治疗角膜穿孔伤合并角膜缺损的有效方法。Objective To evaluate the clinical effect of lamellar keratoplasty for corneal perforating injuries with corneal defects. Methods Fifty-four cases （54 eyes） of corneal perforating injuries with corneal defects were randomly divided into observation group （21 eyes） and control group （33 eyes）. Patients in observation group accepted lamllar keratoplasty, while patients in control group accepted debridement and suturing. The best corrected visual acuity, corneal astigmatism and intraocular pressure were observed 3 months after the operation. Results At the last follow-up, the corneas of patients in observation group remained transparent and restored to the normal thickness. There were no complications such as corneal haze, scar, graft rejection or postoperative rise of intraocular pressure. The postoperative visual acuity was 0. 1-0.3 in 15 eyes, 0.4-0.5 in 2 eyes and the visual acuity improved in 17 eyes accounting for 80.95%. While in control group, the postoperative visual acuity was 0.08-0.3 in 14 eyes, 0.4-0.5 in 2 eyes and the visual acuity improved in 16 eyes accounting for 48.48%. The difference in the percentage of visual acuity improvement between the two groups was statistically significant （X^2 = 5.69, P = 0.017）. The mean corneal astigmatisms were （ -1.50± 0.25） D in observation group and （ -4.50 ± 0.75） D in control group and the difference was statistically significant （t = 17. 66, P = 0. 013）. Postoperative intraocular pressure was normal in both groups. Conclusion Lamellar keratoplasty is an effective method for corneal perforating injuries with corneal defects.

关 键 词：角膜穿孔伤 角膜缺损 角膜移植 板层 效果 临床 

分 类 号：R779.6[医药卫生—眼科]