摘要
背景:角膜移植可主要分为以恢复角膜透明性和提高视力为主要原因的光学性角膜移植和以修补及重建角膜完整性为主要原因的治疗性或结构性角膜移植。目的:对比分析深板层角膜移植与穿透性角膜移植成功率和降低并发症发生率的临床效果。方法:分析深板层角膜移植和穿透性角膜移植患者43例43眼,26例26眼行深板层角膜移植,17例17眼行穿透性角膜移植,供体角膜均来自死亡后的捐献,24h内4℃湿房保存,移植后用药常规抗炎抗排斥反应,随访3～37个月,观察两组移植前后的裸眼视力和矫正视力,对比疗效、排斥反应、并发症。结果与结论:与移植前比较,两组患者移植后裸眼视力和矫正视力均有提高(P<0.05)。深板层角膜移植后并发症为后弹力膜穿孔1例,移植排斥反应2例,穿透性角膜移植后青光眼1例,虹膜前粘连1例,排斥反应4例。深板层角膜移植可以减少排斥反应的发生率和并发症,移植后视力恢复与穿透性角膜移植无明显差异,但建议内皮功能正常的角膜基质病变可尽量选择深板层角膜移植。
BACKGROUND： Corneal transplantation comprises optical penetrating corneal transplantation and therapeutic corneal transplantation, which aimed to recover the corneal transparency, increase visual acuity or reconstruct corneal integrity. OBJECTIVE： To compare the clinical results in improving the success rate and reducing complications following deep lamellar corneal transplantation and penetrating corneal transplantation. METHODS： A total of 43 cases （43 eyes） receiving deep lamellar corneal transplantation and penetrating corneal transplantation were selected, including 26 cases （26 eyes） receiving deep lamellar corneal transplantation and 17 patients （17 eyes） receiving penetrating corneal transplantation. Donor corneas were from donations after death and preserved within 24 h in 4 ℃ wet room. Routine anti-inflammatory medication was used following transplantation. All patients were followed up for 3-37 months. The naked vision and corrected visual acuity were observed before and after transplantation, the therapeutic effect, rejection and complication were compared. RESULTS AND CONCLUSION： The naked vision and corrected visual acuity in the two groups were improved after transplantation （P 0.05）. One case suffered from posterior elastic membrane perforation and 2 cases of rejection following deep lamellar corneal transplantation. One case suffered glaucoma, 1 case with anterior synechia, and 4 cases with rejection following penetrating corneal transplantation. Deep lamellar corneal transplantation can reduce the incidence of rejection and complications, though there were no differences in restoring vision compared with penetrating corneal transplantation, patients with normal corneal endothelial lesions may be advised to select deep lamellar corneal transplantation.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2010年第31期5841-5844,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
