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1、穿透性角膜移植治疗外伤性角般病变的临床观察作者:陈国苍,陈梅珠,杨丽霞,余鹰翔,王云鹏单位:350025)中国福建省福州市,南京军区福州总医院眼科【摘要】目的:探讨穿透性角膜移植术治疗外伤性角膜病变的临床疗效。方法:对17例外伤性角膜病变施行穿透性角膜移植术,2例行穿透性角膜移植术联合小梁切除术,观察术后角膜植片及视力变化。结果:随访6〜18(平均11.2)mo,术后临床症状明显缓解或消失,植片透明率为84%o视力较术前提高,其中矫正视力0.05以上16例;术后继发性青光眼5例,内皮型排斥反应4例。结论:穿透性角膜移植
2、术是治疗外伤性角膜病变的--种有效的手术方式,其主耍并发症为继发性青光眼和角膜移植排斥反应。【关键词】穿透性角膜移植;外伤性角膜病变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引言外伤性角膜病变是常见的的致盲原因之一,角膜移植是能够恢复这些患者的视力的唯一手段。木文冋顾性分析穿透性角膜移植(penetratingkeratoplasty,PPK)治疗外伤性角膜病变19例,对其临床特点和治疗述行总结,报告如下。1对象和方法1.1对象19例患者中,男16例,女3例。患者年龄7〜53(平均2&5)岁。临床检查:术前均行眼部B超检查,发现视网膜、脉络膜脱离者排除在木组病例外。(1)单纯外伤性角膜白斑3眼;(2)角膜口斑合并人工晶状体眼5眼(3)角膜白斑合并无晶状体眼8眼(4)多发性介膜深
8、层异物2例(5)人泡性和膜炎合并后房非金属异物1眼。外伤后介膜病变时间为Imo〜2a。术前视力:19眼屮光感或眼前手动者3眼,视力≤0.()5者12眼,().05以上4眼。1・2方法采川球后麻醉和局部浸润麻醉。行穿透性介膜移植17例,联合小梁切除术2例。角膜移植片取材于湿房保存的新鲜材料,手术在供眼采集后4〜6h内进行。术前