离子电渗跨上皮角膜交联术治疗薄型圆锥角膜临床疗效观察  

Clinical effects of iontophoresis transepithelial CCL on treatment of thin keratoconus

作　　者：张志长[1] 吴競[1] 宫学武[1] 盛莉杰 

机构地区：[1]齐齐哈尔医学院附属第二医院眼科,黑龙江齐齐哈尔161000

出　　处：《西南国防医药》2016年第7期773-776,共4页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的探讨离子电渗跨上皮角膜交联术治疗薄型圆锥角膜的临床疗效及对患者视力的改善作用。方法选取收治的进展期圆锥角膜患者49例。均接受离子电渗跨上皮角膜交联术治疗,对比患者治疗前后眼部疼痛程度、角膜内皮细胞数量、临床症状以及共聚焦显微镜检查结果。结果术后1 d患者疼痛感和异物感均明显高于术前,术后3 d疼痛感和异物感较术后1 d明显降低(P<0.05),术后7 d疼痛感和异物感明显低于术前(P<0.05),并且症状基本消失。术后6个月,裸眼视力明显提高者14例;最佳矫正视力明显提高15例,视力明显降低者2例。术后6个月,最大角膜曲率和最小角膜曲率均明显低于术前(P<0.05),并且患者模拟散光度数显著降低(P<0.05),但角膜中央3.0 mm和5.0 mm区域不规则性与术前比较无显著变化(P>0.05)。术后1个月OCT、共聚焦显微镜检查可见角膜浅层基质明显改善,基质细胞数量减少,纤维直径显著增粗,纤维间连接更紧密,且数量明显增加。结论采用离子电渗跨上皮角膜交联术治疗薄型圆锥角膜疗效确切,可有效改善患者角膜曲率,手术时间较短,且术后康复较快,具有临床应用及推广价值。Objective To explore the clinical effects of iontophoresis transepithelial CCL on the treatment of thin keratoconus and the improvement of the vision of patients. Methods A total of 49 keratoconus patients, who were at progressive stage and had been admitted to our hospital, were selected. They received iontophoresis transepithelial CCL in order to compare the degree of ocular pain, the number of corneal endothelial cells, clinical symptoms and the results of confocal microscopy examination before and after the treatment. Results The pain and foreign body sensation one day after the operation were much greater than those before the operation; the pain and foreign body sensation three days after the operation were much milder than those one day after the operation （P 〈 0.05）; and the pain and foreign body sensation seven days after the operation were much milder than those before the operation （P 〈 0.05）; and the symptoms basically disappeared. Six months after the operation, 14 patients＂ naked vision improved greatly; the best corrected visual acuity of 15 patients improved significantly; and the vision of two patients decreased obviously. Besides, six months after the operation, the maximum and the minimum corneal curvatures were significantly lower than those before the operation （P 〈 0.05）, and the simulated astigmatism degree of patients decreased significantly （P 〈 0.05）. However, the irregularity of the 3.0 mm and 5.0 mm areas in the middle of cornea showed no significant change compared with that before the operation （P 〉 0.05） .One month after the operation, the substantial improvement of corneal shallow substrate was shown by OCT and confocal microscopy examination. The number of stroma cells decreased; fiber diameter increased greatly; the inter-fiber connection got closer; and the number of fibers increased substantially. Concision The treatment of thin keratoconus with iontophoresis transepithelial CCL shows definite clinical effects and can effectively improve the corn

关 键 词：离子电渗 角膜交联术 薄型圆锥角膜 疗效 并发症 视力 

分 类 号：R772.2[医药卫生—眼科]