飞秒激光蘑菇状切口穿透性角膜移植联合白内障摘除术的临床研究  

Clinical research of femtosecond laser mushroom incision penetrating corneal transplantation combined cataract extraction

作　　者：曹雪倩 王林农[1] 周如侠 Cao Xueqian;Wang Linnong;Zhou Xiaru(Department of Ophthalmology,Nanjing Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;Department of Ophthalmology,Nanjing Affiliated Jiangning Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学附属南京医院,南京210006 [2]南京医科大学附属江宁医院眼科

出　　处：《中国实用眼科杂志》2017年第8期779-784,共6页Chinese Journal of Practical Ophthalmology

摘　　要：目的 评价飞秒激光蘑菇状切口穿透性角膜移植（femtosecond-assisted penetrating keratoplasty,FS-PKP）联合白内障摘除术的疗效及安全性.方法 回顾性分析29例30眼FS-PKP联合白内障囊外摘除病例（飞秒组）,将11例11眼同期行传统PKP联合白内障囊外摘除的病例作为对照组.两组角膜病变累及全层,且患者晶状体中等及以上程度混浊.飞秒组用飞秒激光制作蘑菇状切口的植片与对应植床;对照组用环钻制作,白内障囊外摘除后植入人工晶体并缝合.所有患者于术后1周、1个月、3个月、6个月随访,部分患者随访达18个月.比较两组随访结果.结果 两组患者术后视力均有提高,飞秒组术后3个月内的裸眼视力及矫正视力均优于对照组,散光值小于对照组,术后6个月后两组间差异无统计学意义.两组术后角膜内皮细胞密度和术后并发症无统计学差异.结论 蘑菇状切口的飞秒辅助穿透性角膜移植联合白内障手术疗效明显,切削精确,安全性高,早期视力恢复优于普通穿透性角膜移植,临床适用范围广.Objective To evaluate the effectiveness and safety of mushroom incision femtosecond-assisted penetrating comeal transplantation combined cataract extraction surgery.Methods A retrospective analysis was carried out for 29 patients （30 eyes） who performed FS-PKP combined cataract extracapsular extraction versus 11 patients （11 eyes） who performed traditional PKP combined cataract extracapsular extraction.Lesions involving whole comea and all the patients＇ lenticular opacity were moderate or above.Femtosecond laser was used for make mushroom incision of comeal graft and corresponding recipient bed,conventional group used trephine.Then implemented cataract extracapsular extraction,intraocular lens were implanted,sutured at last.Their follow-up were 1 week,1 month,3 months and 6 months,part of the patient were followed up until 18 months.The follow-up results of two groups were compared.Results Postoperative vision of two groups had increased,postoperative UCVA and BCVA of femtosecond group were better than normal group,postoperative astigmatism was lower than normal group within 3 months,and there was no obvious difference after 6 months.No obvious difference was found between two groups of ECD and postoperative complications occurrence rate.Conclusions Mushroom incision of femtosecond-assisted penetrating corneal transplantation combined cataract extraction surgery has obvious curative effect,precision cutting and high security,its early visual acuity is superior to the traditional penetrating keratoplasty,it can be widely used in clinical therapy.

关 键 词：飞秒激光 角膜移植术 白内障 穿透性 角膜白斑对照 

分 类 号：R779.65[医药卫生—眼科]