摘要
目的探讨心脏死亡后捐献(donation after cardiac death,DCD)角膜供体行穿透性角膜移植术后泪膜功能的变化。方法对27例2016年3月至2017年3月之中在昆明市第一人民医院行DCD来源的穿透性角膜移植术的患者,以自体健眼作为对照组。分别于术前、术后1周、术后1～6月进行随访,双眼均做系统检查:裂隙灯下角膜、前房深度、虹膜等前节检查并行患者主观感觉问卷、双眼泪膜破裂时间(BUT)、泪河高度检查。使用SPSS将结果作统计学t检验分析。结果 (1)当无角膜移植排斥反应时,穿透性角膜移植术后6个月内术眼泪膜破裂时间低于健眼(P<0.05),但患者无明显眼部干眼等症状;泪河高度值在6个月内比较健眼有统计学意义(P<0.05);(2)当排斥发生时,术眼泪膜破裂时间为0;术眼泪河高度明显高于健眼。结论穿透性角膜移植术后6个月内,术眼的泪膜稳定性尚未恢复到正常水平,当发生排斥反应时稳定性急剧下降,在术后随访中依据病情使用角膜营养、抗排斥、神经营养药物等提前预防干眼症、角膜排斥等并发症。
Objective To discover the function changes after penetrating corneal transplantation of donation after cardiac death(DCD).Methods 27 patients with penetrating keratoplasty in the First People's Hospital of Kunming,from March 2016 to March 2017,were chosen as the control group and treated with penetrating corneal transplantation.Patients were followed up preoperatively,1w postoperatively,and 1-6 m postoperatively.Systematic examinations were performed in both eyes:cornea,anterior chamber depth,iris and other anterior segment examinations under slit lamp,subjective sensation questionnaire of patients,tear film rupture time(BUT)in both eyes,and tear river height examination.SPSS 21.0 was used to analyze the Results.Result(1)When there is no corneal graft rejection,the tear film rupture time was lower than that of the healthy eye(P<0.05)in 6 months after the surgery,but the patient had no obvious symptoms such as dry eye.The height of the lacrimal river was statistically significant in 6 months(P<0.05).(2)When the rejection occurs,the time of the tear film is 0;The height of the tears river is significantly higher than that of the healthy eye.Conclusion Six months after penetrating corneal transplantation surgery,the eye-stability has not recovered to normal level.When being rejected,the stability fell sharply.In postoperative follow-ups,corneal nutrition,anti-rejection,neurotrophic drugs and other drugs were used according to the condition to prevent complications such as dry eye disease and corneal rejection in advance
作者
范雅馨
李兰
曹倩
李勇
邹莹
田二苗
FAN Ya-xin;LI Lan;CAO Qian;LI Yong;ZOU Ying;TIAN Er-miao(Dept.of Ophthalmology,Affiliated Calmette Hospital of Kunming Medical University,Kunming Yunnan 650051,China)
出处
《昆明医科大学学报》
CAS
2019年第1期101-104,共4页
Journal of Kunming Medical University
基金
昆明市科技局计划重点基金资助项目(2014-04-A-S-02-2091)
关键词
穿透性角膜移植
泪膜破裂时间
泪河高度
Penetrating corneal transplantation
Breakup time of tear film
Height of the river of tears
