Sinha R, Vanathi M, Sharma N, Titiyal J S, Vajpayee R B, Tandon R
Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India.
Eye (Lond). 2005 Apr;19(4):451-4. doi: 10.1038/sj.eye.6701534.
To evaluate the outcome of penetrating keratoplasty in patients with bilateral corneal blindness.
Bilaterally blind patients who had undergone optical penetrating keratoplasty (PK) were evaluated on optical and refractive parameters and presence of complications if any. The results at 3 months, 6 months, and 1 year were compared with age-matched and indication-matched unilaterally blind controls.
The most common indication for surgery in both the groups was the presence of a corneoiridic scar. Best corrected visual acuity of > or =6/18 was seen in five (16.66%) patients in the study group and in 11 (36.66%) patients in the control group (P = 0.14). In all, 15 (50%) grafts in the study group and six (20%) in the control group failed (P = 0.03). The most common cause of failure was graft infection (40%) in the study group and post-PK glaucoma (20%) in the control group. The percentage of graft rejection as a cause of graft failure was the same in both the groups. A composite socioeconomic status scale based on family literacy and income suggested that 70% of the cases in the study group and 30% in the control group belonged to the low socioeconomic group (P = 0.004).
The outcome of optical penetrating keratoplasty in patients with bilaterally blinding corneal disease is poorer than those who are unilaterally blind. Low socioeconomic status may be a contributing factor for the poor outcome.
评估双侧角膜盲患者穿透性角膜移植术的效果。
对接受光学穿透性角膜移植术（PK）的双侧盲患者进行光学和屈光参数评估，并检查是否存在并发症。将3个月、6个月和1年时的结果与年龄匹配且适应证匹配的单侧盲对照组进行比较。
两组中最常见的手术适应证是角膜虹膜瘢痕。研究组中有5例（16.66%）患者最佳矫正视力≥6/18，对照组中有11例（36.66%）患者最佳矫正视力≥6/18（P = 0.14）。研究组中共有15例（50%）移植片失败，对照组中有6例（20%）移植片失败（P = 0.03）。失败的最常见原因在研究组中是移植片感染（40%），在对照组中是穿透性角膜移植术后青光眼（20%）。两组中因移植片排斥导致移植片失败的百分比相同。基于家庭文化程度和收入的综合社会经济地位量表显示，研究组中70%的病例和对照组中30%的病例属于低社会经济群体（P = 0.004）。
双侧致盲性角膜疾病患者的光学穿透性角膜移植术效果比单侧盲患者差。低社会经济地位可能是导致效果不佳的一个因素。
