摘要
目的应用前节光学相干断层扫描技术(anterior segment optical coherence tomography,AS-OCT)对BostonⅠ型人工角膜移植术后患者进行观察。方法收集2007年2月-2018年6月于解放军总医院第一医学中心眼科病房行BostonⅠ型人工角膜移植术患者31例(31眼)的临床资料,分析其术后1周、1个月、3个月、6个月、1年时最佳矫正视力(best correctedvisual acuity,BCVA)及应用AS-OCT进行观察的结果。结果所有患者均顺利植入BostonⅠ型人工角膜并应用AS-OCT观察1年。所有病例人工角膜植入眼术前视力为光感或手动;术后1年内,BCVA恢复至0.05~0.8,平均0.41±0.25,BCVA于术后1周、1个月、3个月、6个月、12个月保持相对稳定(P=0.779)。术后1个月AS-OCT观察到人工角膜镜前增殖膜生长,至术后1年共出现7例(7/31,22.6%);术后3~6个月,共6例出现角膜交界面组织溶解(6/31,19.4%)。根据AS-OCT结果,1例于术后6个月进行角膜镜前增殖膜切除手术,6例患者因角膜交界面组织溶解进行修补手术(2例于术后3个月修补,3例于术后6个月修补,1例随访至术后9个月修补)。结论BostonⅠ型人工角膜移植手术后1年是并发症高发期,AS-OCT可用于观察人工角膜前增殖膜及供体角膜交界面组织溶解,为及时处理并发症提供依据,从而稳定术后最佳矫正视力。
Objective To evaluate the outcomes of Boston typeⅠkeratoprosthesis implantation by anterior segment optical coherence tomography(AS-OCT).Methods Clinical data about 31 patients(31 eyes)who received Boston typeⅠkeratoprosthesis in the eye center of the First Medical Center of Chinese PLA General Hospital from February 2007 to June 2018 were reviewed retrospectively.There were 26 males and 5 females with the age ranging from 18 to 71 years.The BCVA was recorded and the AS-OCT examination results at different timepoints after operation were analyzed.Results TypeⅠBoston keratoprosthesis was successfully implanted in all the cases and followed up for 1 year.Preoperative vision in 31 cases(31 eyes)was light perception or hand move,and the postoperative BCVA ranged from 0.05 to 0.8,with average of 0.41±0.25.At 1 week,1 month,3 months,6 months and 12 months after operation,the BCVA did not changed significantly(P=0.779).According to AS-OCT,the anterior membrane of artificial cornea was found in 7 cases(7/31,22.6%)since 1 month after operation,and 1 case underwent anterior membrane of artificial cornea resection at 6 months after operation.The KPro corneal melt was found locally in 6 cases(6/31,19.4%)from 3 months to 6 months after operation,and all of them underwent repair operation(2 cases underwent repair operation at 3 months after operation,3 cases at 6 months after operation,1 case at 9 months after operation).Conclusion The incidence of complications is high in the first year after Boston typeⅠkeratoprosthesis.AS-OCT is an effective tool to observe the KPro corneal melt and the growth of anterior membrane of artificial cornea,and provides evidence for timely treatment of complications,so as to stabilize the BCVA after operation.
作者
杨青华
谢小燕
林芳丽
徐泽全
王丽强
黄一飞
YANG Qinghua;XIE Xiaoyan;LIN Fangli;XU Zequan;WANG Liqiang;HUANG Yifei(Department of Ophthalmology,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Ophthalmology and Optometry Teaching and Research Section,Changzhou Hygiene Vocational Technology College,Changzhou 213000,Jiangsu Province,China)
出处
《解放军医学院学报》
CAS
2020年第7期683-686,696,共5页
Academic Journal of Chinese PLA Medical School
关键词
前节光学相干断层成像
BostonⅠ型人工角膜
角膜移植
anterior segment optical coherence tomography
Boston typeⅠkeratoprosthesis
corneal transplantation
