深板层角膜移植术治疗感染性角膜穿孔临床疗效分析  

Clinical Efficacy Analysis of Deep Lamellar Keratoplasty in Treatment of Infected Corneal Perforation

作　　者：郝珍珍 李海燕 乔玉春 李悦璇 骆非 HAO Zhen-zhen;LI Hai-yan;QIAO Yu-chun;LI Yue-xuan;LUO Fei(The Fourth Hospital of Zhangjiakou City,Zhangjiakoun,Hebei 075000,China)

机构地区：[1]河北省张家口市第四医院,河北张家口075000

出　　处：《河北北方学院学报（自然科学版）》2023年第10期1-4,8,共5页Journal of Hebei North University:Natural Science Edition

基　　金：张家口市重点研发计划项目(No.2121118D)

摘　　要：目的探讨深板层角膜移植术治疗感染性角膜穿孔的临床疗效。方法回顾性分析40例(40眼)感染性角膜穿孔患者的临床资料,所有患者均经深板层角膜移植术(DALK)治疗。分析患者眼球完整性、眼球穿孔的原因,术前及术后1、3、6、12个月的最佳矫正视力、屈光度、内皮细胞密度及术后并发症情况。结果40只眼术后均恢复眼球完整性,术前视力及术后1、3、6、12个月的视力分别为(1.75±0.91)、(1.33±0.91)、(1.33±0.92)、(1.25±0.93)、(1.14±0.83)。术后1个月与术前视力比较差异无统计学意义(P>0.05),术后3个月与术后1个月视力比较差异无统计学意义(P>0.05),术后6、12个月视力与术前比较差异均具有统计学意义(P<0.05),术后12个月视力较术后1、3个月均有明显提高且差异有统计学意义(P<0.05)。随访期间出现双前房1例,自行消退;高眼压1例、植片排斥1例,通过治疗均痊愈并且未再次发生;并发性白内障1例,通过白内障超声乳化摘除术联合人工晶体植入术治愈。结论深板层角膜移植治疗感染性角膜穿孔安全、有效,可实现眼球构造的完整性,提高患者视力。Objective To investigate the clinical effect of deep lamellar keratoplasty in the treatment of infectious corneal perforation.Methods A retrospective study was performed on 40 patients(40 eyes)with infectious corneal perforation.All patients were treated with deep lamellar keratoplasty(DALK).The integrity of the eyeball,the cause of eyeball perforation,the best corrected visual acuity,refraction,endothelial cell density and postoperative complications before and 1,3,6,and 12 months after surgery were analyzed.Results All 40 eyes recovered eyeball integrity.The visual acuity of 40 patients before and 1,3,6 and 12 months after surgery were(1.75±0.91),(1.33±0.91),(1.33±0.92),(1.25±0.93),(1.14±0.83).Visual acuity at 1 month after operation was not significantly different from that before operation(P>0.05),and there was no significant difference in visual acuity at 1 month after operation and 3 months after operation(P>0.05).Visual acuity at 6,and 12 months after operation was compared with that before operation,and the differences were statistically significant(P<0.05);visual acuity at 12 months after operation significantly improved compared to 1,3 months after operation,and the difference was statistically significant(P<0.05).During the follow-up period,1 case of double anterior chamber developed and resolved spontaneously;1 case of high intraocular pressure and 1 case of graft rejection were cured by treatment and did not recur,and 1 case of concurrent cataract was cured through phacoemulsification combined with intraocular lens implantation.Conclusion Deep lamellar keratoplasty is safe and effective in the treatment of infectious corneal perforation,which can achieve the integrity of the eyeball structure and improve the vision of patients.

关 键 词：角膜移植 深板层 感染性角膜穿孔 

分 类 号：R779.65[医药卫生—眼科]