摘要
目的:观察生物工程角膜应用于感染性角膜炎的治疗效果。方法:对成都爱迪眼科医院19例采用生物工程角膜治疗的感染性角膜病角膜植片存活状况、术后视力变化及并发症进行回顾性分析。与同期22例人来源供体角膜移植行术后排异对比。结果:在19例患者中,女9例(47.37%),平均年龄53.32岁;病因中细菌性角膜炎7例(36.84%),真菌性角膜炎8例(42.11%),病毒性角膜炎4例(21.05%)。术前裸眼视力检查:光感3例(光定位准),手动5例,眼前指数4例,3.0~3.9者7例。随访1~14个月未发生原发感染复发;植片成活18例(94.74%),1例1月内植片溶解再手术(5.26%)。裸眼视力4.0~4.5者15例(78.95%),3.0~4.0者3例(15.79%),数指1例(5.26%)。远期(6~12个月以上)生物工程角膜移植术后角膜缘新生血管更易侵入,以植片缘环形浑浊为主。两组间排异差异无统计学意义(Mann-Whitney检验,P=0.736)。结论:生物工程角膜具有较好的人角膜结构替代功能,对未累及全层的感染性角膜疾病起到较好的结构和功能重建作用,恢复有用视力,缓解角膜供体来源不足,有一定推广意义。
Objective: To observe the outcomes of bioengineered cornea for lamellar keratoplasty in the infectious keratitis.Methods:A total of 19 cases with infectious keratitis treated by bioengineered cornea in Chengdu Aidi Eye Hospital were analyzed retrospectively.The results of graft survival,visual acuity and complications were collected.Rejection reaction was compared with 22 cases of human donor corneal lamellar keratoplasty during the same period.Results:In the 19 cases patients,9 cases were women(47.37%) with the average age of 53.32 years.Among the pathogenic factors,7 cases were bacterial keratitis(36.84%),8 cases were fungal keratitis(42.11%) and 4 cases were viral(21.05%).The results of preoperative uncorrected visual acuity(UCVA) showed that 3 cases were light perception(accurate light positioning),5 cases were hand moving,4 cases were counting finger,and7 cases were in the range of 3.0-3.9.In the follow-up,no case of primary infection recurrence occurred;18 grafts survived except one case dissolved end with re-transplant by human donor.The postoperative UCVA of 15 cases(78.95%) were in the range of 4.0-4.5,3 cases were in the range of 3.0-4.0(15.79%),and 1 case of counting finger(5.26%).There was no significant difference in rejection action(P=0.736).In the followup more than 6-12 months,the limbal neovascularization of the biological engineering cornea is more likely to invade with the result of ring shape opacity at the graft edge.Conclusion:The biological engineering cornea can play a good role in the reconstruction for the cases with infectious keratitis.It provides another way to solve the shortage of corneal grafts.
作者
康黔
杨雨昆
姚晓明
KANG Qian;YANG Yukun;YAO Xiaoming(Department of Cornea,Chengdu Aidi Eye Hospital,Chengdu 610072,China)
出处
《眼科学报》
CAS
2022年第4期271-280,共10页
Eye Science
