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1、穿透性角膜移植治療外傷性角般病變的臨床觀察作者:陳國(guó)蒼,陳梅珠,楊麗霞,余鷹翔,王云鵬單位:350025)中國(guó)福建省福州市,南京軍區(qū)福州總醫(yī)院眼科【摘要】目的:探討穿透性角膜移植術(shù)治療外傷性角膜病變的臨床療效。方法:對(duì)17例外傷性角膜病變施行穿透性角膜移植術(shù),2例行穿透性角膜移植術(shù)聯(lián)合小梁切除術(shù),觀察術(shù)后角膜植片及視力變化。結(jié)果:隨訪6?18(平均11.2)mo,術(shù)后臨床癥狀明顯緩解或消失,植片透明率為84%o視力較術(shù)前提高,其中矯正視力0.05以上16例;術(shù)后繼發(fā)性青光眼5例,內(nèi)皮型排斥反應(yīng)4例。結(jié)論:穿透性角膜移植
2、術(shù)是治療外傷性角膜病變的--種有效的手術(shù)方式,其主耍并發(fā)癥為繼發(fā)性青光眼和角膜移植排斥反應(yīng)。【關(guān)鍵詞】穿透性角膜移植;外傷性角膜病變ClinicalobservationofpenetratingkeratoplastyfortreatmentoftraumatickeratopathyGuoCangChen,MeiZhuChen,LiXiaYang,YingXiangYu,YunPengWangDepartmentofOphthalmology,FuzhouGeneralHospitalofNanjingMilita
3、ryCommand,Fuzhou350025,FujianProvince,ChinaConespondenceto:GuoCangChen.DepartmentofOphthalmology,FuzhouGeneralHospitalofNanjingMilitaiyCommand,Fuzhou350025,FujianProvince,China,gcchenys@sina.comAbstractAIM:Toevaluatetheeffectofpenetratingkeratoplastyontreatmento
4、ftraumatickeratopathy.METHODS:Seventeencasesoftraumatickeratopathyweretreatedbypenetraingkeratoplasty,while2casesunderwentpenetratingkeratoplastycombinedwithtrabeculectomy.Cornealgraftsandthechangesinvisualacuitywereobservedafteroperation.RESULTS:Cornealgraftsan
5、dthechangesinvisualacuitywerefollowedupfor6to18months(11.2monthsonaverage).Alltheclinicalsymptomsremittedordisappeared,thebuttonsweretransparentandpostoperativevisualacuitywasimproved.Sixteeneyeshadacorrectedvisualacuityof0.05orbetterand4eyeshad0.2orbette匚Fiveca
6、sesofsecondaryglaucomaand4casesofendothelialrejectionwerefound.CONCLUSION:Thepenetratingkeratoplastyfortreatmentoftraumatickeratopathywaseffective.Postoperatively,theprimarycomplicationsareglaucomaandgraftrejection.KEYWORDS:penetratingkeratoplasty;traumatickerat
7、opathy引言外傷性角膜病變是常見的的致盲原因之一,角膜移植是能夠恢復(fù)這些患者的視力的唯一手段。木文冋顧性分析穿透性角膜移植(penetratingkeratoplasty,PPK)治療外傷性角膜病變19例,對(duì)其臨床特點(diǎn)和治療述行總結(jié),報(bào)告如下。1對(duì)象和方法1.1對(duì)象19例患者中,男16例,女3例?;颊吣挲g7?53(平均2&5)歲。臨床檢查:術(shù)前均行眼部B超檢查,發(fā)現(xiàn)視網(wǎng)膜、脈絡(luò)膜脫離者排除在木組病例外。(1)單純外傷性角膜白斑3眼;(2)角膜口斑合并人工晶狀體眼5眼(3)角膜白斑合并無(wú)晶狀體眼8眼(4)多發(fā)性介膜深
8、層異物2例(5)人泡性和膜炎合并后房非金屬異物1眼。外傷后介膜病變時(shí)間為Imo?2a。術(shù)前視力:19眼屮光感或眼前手動(dòng)者3眼,視力≤0.()5者12眼,().05以上4眼。1?2方法采川球后麻醉和局部浸潤(rùn)麻醉。行穿透性介膜移植17例,聯(lián)合小梁切除術(shù)2例。角膜移植片取材于濕房保存的新鮮材料,手術(shù)在供眼采集后4?6h內(nèi)進(jìn)行。術(shù)前