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穿透性角膜移植联合虹膜缝合人工晶状体植入术的长期疗效

Long-term outcomes of combined penetrating keratoplasty with iris-sutured intraocular lens implantation.

作者信息

Akpek Esen Karamursel, Altan-Yaycioglu Rana, Karadayi Koray, Christen William, Stark Walter J

机构信息

The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

出版信息

Ophthalmology. 2003 May;110(5):1017-22. doi: 10.1016/S0161-6420(03)00097-6.

Abstract

PURPOSE

To evaluate the long-term outcomes of combined penetrating keratoplasty with iris-sutured posterior chamber intraocular lens implantation.

PARTICIPANTS

Patients (264 eyes) with aphakic and pseudophakic bullous keratopathy.

DESIGN

Retrospective case series.

INTERVENTION

Penetrating keratoplasty combined with implantation of an iris-sutured posterior chamber intraocular lens performed by a single surgeon.

METHODS

Data were gathered from the institutional database during a period of 10 years (1989-1999) and analyzed using customized software.

MAIN OUTCOME MEASURES

Graft survival rate, visual acuity, and intraoperative and postoperative complications.

RESULTS

Two-hundred fifty-two consecutive patients (264 eyes) were operated. Graft survival rates were 95% at 1 year, 89% at 2 years, and 81% at 5 years and were comparable to the results of previous corneal transplant studies. Among 180 patients (191 eyes) with a follow-up of at least 2 years (range, 2-11 years; mean, 5 years), the visual acuity at final follow-up visit, compared with preoperative visual acuity was improved in 72% of eyes (mean preoperative visual acuity, 20/250; mean postoperative visual acuity, 20/60). No intraoperative complications were encountered.

CONCLUSIONS

Combined penetrating keratoplasty with iris-sutured posterior chamber intraocular lens implantation offers significant vision benefits in this patient group.

摘要

目的

评估穿透性角膜移植联合虹膜缝合后房型人工晶状体植入术的长期效果。

参与者

无晶状体和假晶状体大泡性角膜病变患者(264只眼)。

设计

回顾性病例系列研究。

干预

由单一外科医生进行穿透性角膜移植联合虹膜缝合后房型人工晶状体植入术。

方法

从机构数据库收集10年期间(1989 - 1999年)的数据,并使用定制软件进行分析。

主要观察指标

植片存活率、视力以及术中及术后并发症。

结果

连续252例患者(264只眼)接受手术。1年时植片存活率为95%,2年时为89%,5年时为81%,与先前角膜移植研究结果相当。在180例(191只眼)随访至少2年(范围2 - 11年;平均5年)的患者中,末次随访时72%的患眼视力较术前提高(术前平均视力为20/250;术后平均视力为20/60)。术中未出现并发症。

结论

穿透性角膜移植联合虹膜缝合后房型人工晶状体植入术为本患者群体带来显著的视力改善。

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