Parmar Pragya, Salman Amjad, Kalavathy C M, Thomas Philip A, Jesudasan C A Nelson
Department of Ophthalmology, Institute of Ophthalmology, Joseph Eye Hospital, Tiruchirapalli 620 001, India.
Cornea. 2005 Mar;24(2):123-9. doi: 10.1097/01.ico.0000138835.06953.db.
To assess the results of cataract surgery, in terms of visual outcome and effect on graft survival, in eyes that have previously undergone therapeutic penetrating keratoplasty for infective keratitis.
Case records of patients who had undergone cataract surgery alone (group A) or in combination with regrafting (group B) following initial therapeutic penetrating keratoplasty between January 2000 and December 2001 were reviewed retrospectively. Main outcome measures studied were visual acuity, astigmatism, and effect of the cataract surgery on graft survival. Results were compared with eyes undergoing cataract surgery after optical keratoplasty and between eyes in groups A and B.
Frequency of cataract surgery after therapeutic keratoplasty was significantly greater than that following optical keratoplasty [68 (52%) versus 47 (21%); P<0.001]. Fifty-eight eyes of 58 patients undergoing cataract surgery after therapeutic penetrating keratoplasty were analyzed in detail. Mean follow-up period was 8.9 months (+/-7.6 months). Thirty eyes underwent cataract surgery alone (group A), and 28 eyes underwent cataract surgery with regrafting (group B). Eyes that had undergone therapeutic keratoplasty were significantly more likely to have opaque grafts requiring regrafting at the time of cataract surgery than eyes that had undergone optical keratoplasty [28 (48.3%) versus 5 (10.6%); P<0.001]. Incidence of graft failure after cataract surgery did not differ significantly in eyes that had undergone therapeutic or optical keratoplasty. Final visual acuity at last follow-up was 6/12 or better in 25 eyes (43%). There were no significant differences between eyes in groups A and B in terms of final visual acuity, astigmatism, or graft failure rates.
Visual results of cataract surgery following therapeutic keratoplasty are comparable to those following optical keratoplasty. Combining a repeat keratoplasty for a failed graft with the cataract surgery does not significantly affect the final outcome.
评估既往因感染性角膜炎接受治疗性穿透性角膜移植术的患眼，白内障手术在视觉效果及对植片存活影响方面的结果。
回顾性分析2000年1月至2001年12月期间，在初次治疗性穿透性角膜移植术后，单独接受白内障手术（A组）或联合再次移植手术（B组）的患者的病例记录。研究的主要观察指标为视力、散光以及白内障手术对植片存活的影响。将结果与接受光学角膜移植术后行白内障手术的患眼进行比较，并在A组和B组的患眼之间进行比较。
治疗性角膜移植术后白内障手术的发生率显著高于光学角膜移植术后[68例（52%）对47例（21%）；P<0.001]。对58例接受治疗性穿透性角膜移植术后行白内障手术的患者的58只眼进行了详细分析。平均随访期为8.9个月（±7.6个月）。30只眼单独接受了白内障手术（A组），28只眼接受了白内障手术并联合再次移植手术（B组）。与接受光学角膜移植术的患眼相比，接受治疗性角膜移植术的患眼在白内障手术时更有可能出现需要再次移植的不透明植片[28只眼（48.3%）对5只眼（10.6%）；P<0.001]。白内障手术后植片失败的发生率在接受治疗性或光学角膜移植术的患眼中无显著差异。最后一次随访时的最终视力在25只眼（43%）中达到6/12或更好。A组和B组的患眼在最终视力、散光或植片失败率方面无显著差异。
治疗性角膜移植术后白内障手术的视觉结果与光学角膜移植术后相当。将失败植片的再次角膜移植术与白内障手术相结合不会显著影响最终结果。
