角膜移植术后植片哆开的临床特征分析  

Investigation of wound dehiscence after keratoplasty

作　　者：王昕 张赛 亓小林 李素霞[2] 杜显丽 高华[2] Wang Xin;Zhang Sai;Qi Xiaolin;Li Suxia;Du Xianli;Gao Hua(College of Medicine of Qingdao University,Qingdao 266071;Shandong Eye Institute,Shandong Eye Hospital,Jinan 250021,China)

机构地区：[1]青岛大学医学院,266071 [2]山东省医学科学院,山东省眼科研究所,山东省眼科医院

出　　处：《临床眼科杂志》2018年第3期207-211,共5页Journal of Clinical Ophthalmology

基　　金：国家自然科学基金(81570821);山东省自然科学基金培养基金(ZR2016HP14);山东泰山学者计划(20081148);山东省优秀创新团队资助项目(TD201208)

摘　　要：目的分析角膜移植术后植片哆开的原发病术式、原因、时间间隔、哆开程度以及预后等临床特征,为临床角膜移植提供安全参考。方法收集山东省眼科医院2011~2016年所行角膜移植术后发生角膜植片哆开的15例病例。记录植片哆开原发病的术式、原因、时间、哆开程度、预后等。结果术式:15例患者(0.67%)发生植片哆开,其中包括穿透性角膜移植术后10例(1.02%)和板层角膜移植术后5例(0.42%)。原因:15例均为外伤所致,发生外伤时患者均未佩戴护目镜。时间:11例(73.33%)患者的植片哆开出现在术后2年内。哆开程度:角膜植片哆开位置均处于植片植床交界处,植片哆开范围在4~9个钟点位。预后:71.4%患者视力较受伤入院时提高。结论角膜植片哆开与多种因素有关,术后未佩戴护目镜是高危因素,术后2年内为高发期,术后应加强患者教育,降低植片哆开风险。Objective To provide the reference for the clinical treatment,we analyze the type of operation,causes,time,characteristic of wound and prognosis of wound dehiscence in patients who treated with keratoplasty.Methods 15 patients happened wound dehiscence and were treated at Shandong eye hospital from 2011~2016.We recorded the type of operation,causes,time,characteristics of wound dehiscence and prognosis.Results The type of operation:2242 cases were treated with keratoplasty in Shandong Eye Hospital from 2011 to 2016.There are 15 corneal transplant patients in this survey,including 10 patients of PKP and 5 patients of LKP.The reason:All wound dehiscence were caused by trauma and none of patients wore safety glasses when they were hurt.The interval between trauma and keratoplasty:73.3%patients occurred wound dehiscence within 2 years.The characteristic of wound dehiscence:All cases occurred wound dehiscence at the graft-host junction.The extent of wound dehiscence range four o'clock to nine o'clock.Prognosis:BCVA(best corrected visual acuity)increased than that after trauma in 10 patients(71.4%).Conclusions Graft wound dehiscence is related to many factors.The patients who do not wear safety glasses have more risk to wound dehiscence.Patients after keratoplasty are prone to occur wound dehiscence in first 2 years.It's critical to wear safety glasses for patients to reduce wound dehiscence.

关 键 词：角膜移植 植片哆开 角膜植片重缝术 

分 类 号：R779.65[医药卫生—眼科]