Sukhija Jaspreet, Jain Arun K
Advanced Eye Center, Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Ophthalmic Surg Lasers Imaging. 2005 Jul-Aug;36(4):303-9.
To study the outcome of therapeutic penetrating keratoplasty in eyes with microbial keratitis.
A prospective database on 134 therapeutic cornea transplants in 134 patients recorded demographic details on age and gender of the patient, indication for surgery, size of the donor and recipient bed, graft clarity, complications, and residual morbidity. Patients included in this analysis had a minimum follow-up of 1 year. All patients underwent therapeutic penetrating keratoplasty by a similar method that involved a donor button that was oversized by 0.5 mm and 16 bites of interrupted sutures.
Most of the 134 ulcers needing therapeutic grafts were bacterial (n = 54) or fungal (n = 54). One hundred eighteen eyes had perforation at presentation. One hundred six (90%) of the therapeutic grafts achieved anatomical success. The most common complication of glaucoma occurred in 22% of eyes with presurgical perforated ulcers and 1% of nonperforated ulcers. Persistent epithelial defects were significantly more frequent in grafts of 9 mm or more (P = .05).
Our results confirm that therapeutic penetrating keratoplasty for infections is successful in restoring anatomic integrity in most eyes.
研究微生物性角膜炎患者治疗性穿透性角膜移植术的疗效。
一项前瞻性数据库记录了134例患者的134例治疗性角膜移植手术，内容包括患者的年龄、性别等人口统计学细节、手术指征、供体和受体植床大小、植片清晰度、并发症及残留病变。纳入本分析的患者最少随访1年。所有患者均采用相似方法进行治疗性穿透性角膜移植术，即使用比受体植床大0.5 mm的供体角膜片，并间断缝合16针。
134例需要治疗性移植的溃疡中，多数为细菌性（n = 54）或真菌性（n = 54）。118只眼就诊时存在穿孔。106例（90%）治疗性移植获得解剖学成功。青光眼是最常见的并发症，术前穿孔性溃疡患者中22%发生青光眼，非穿孔性溃疡患者中1%发生青光眼。植片直径9 mm及以上者持续性上皮缺损明显更常见（P = .05）。
我们的结果证实，感染性疾病的治疗性穿透性角膜移植术在多数眼中能成功恢复解剖完整性。
