摘要
目的探讨小切口深板层角膜内皮移植(Deep lamellar posterior endothelial keratoplasty,DLEK)的手术方法、临床效果及手术并发症。方法无对照的前瞻性临床研究。受体后板层通过5mm 切口从眼内取出,植片折叠后通过该切口移植到受体眼内。术后随访角膜伤口的愈合、角膜厚度、角膜散光、角膜内皮细胞密度和矫正视力。结果 21例大泡性角膜病变的患者中,20例完成 DLEK 术,19例术后获得透明角膜 3个月时平均角膜厚度(497.4±35.3)μm,平均角膜内皮细胞密度(1540.5±515.7)个/mm^2.平均角膜散光(2.7±1.2)D。术后矫正视力较术前均有提高。主要并发症为术中值床的穿破,术后植片脱落及值床、植片间的间隙。结论小切口深板层角膜内皮移植可有效治疗大泡性角膜病变,初步临床效果满意。
Purpose To evaluate the clinical results and complications of the treatment of bullous keratopathy, using small incision deep lamellar endothelial keratoplasty （DLEK） surgical technique. A prospective, noncomparative, interventional case series was designed. Methods Twenty one eyes of 21 patients with bullous keratopathy were included in this study. Through a 5-mm seleral incision, a deep lamellar pocket was created across the cornea, followed by excision of the disk of posterior lamellar corneal tissue. Same size lamellar donor disk was folded and placed in position without the need of suture fixation. The healing of corneal wounding, best spectacle-corrected visual acuity （BSCVA）, astigmatism, endothelial cell density （ECD）, and corneal thickness were examined and analyzed. Results Twenty eyes completed DLEK surgeries, one eye was converted to penetrating keratoplasty （PK） at the time of DLEK surgery because of rupture of the recipient＇ s bed. At 3 months after surgery, 19 DLEK corneas were clear and the grafts were healed in good position. Post-operative average pachymetry was 497.4 ± 35.35 tnn and ECD, 1540.5 ± 515.7 cells/mm^2. BSCVA was improved in all the patients. The complications included corneal rupture, donor disk dislocation and dis-adherence between recipient＇ s bed and donor disc. Conclusion small incision DLEK procedure is a safe procedure that provides healthy donor endothelial cell count and function postoperatively, with encouraging visual results.
出处
《中国眼耳鼻喉科杂志》
2006年第6期354-356,I0005,共4页
Chinese Journal of Ophthalmology and Otorhinolaryngology
基金
浦东新区科技发展基金科技专项基金项目(PKJ2005-29)
