Shen Yun-Dun, Chen Wei-Li, Wang I-Jong, Hou Yu-Chih, Hu Fung-Rong
Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
Ophthalmology. 2005 Nov;112(11):1955. doi: 10.1016/j.ophtha.2005.06.015. Epub 2005 Sep 15.
To assess the surgical outcomes in patients who underwent lamellar keratoscleroplasty with full-thickness central corneal grafts for limbal dermoids.
Retrospective, noncomparative, analysis of a consecutive case series with chart review.
Ten patients (6 male, 4 female; mean age, 12.3+/-5.0 years; range, 5.7-22.4 years) with 10 limbal dermoids in 10 eyes undergoing lamellar keratoscleroplasty with full-thickness central corneal grafts between 1992 and 2003 at National Taiwan University Hospital were studied.
The medical records and external eye photographs were reviewed.
Best-corrected visual acuity (BCVA), corneal astigmatism and topography, cosmetic outcomes, and surgical complications were measured as outcome indicators. For analysis of the surgical effect on corneal astigmatism, the 9 patients with topographic data available were divided into 2 groups according to their preoperative corneal astigmatism (group 1, > or =6 diopters [D]; group 2, <6 D).
The mean earliest recorded BCVA and the latest postoperative BCVA were 6/30 and 6/10, respectively, and the improvement of BCVA after operation combined with amblyopia treatment was 4.9+/-3.6 lines on a Snellen chart. Patients with preoperative astigmatism > or =6.0 D (9.7+/-1.0 D; n = 4) were found to have a marked decrease in astigmatism after surgery (astigmatism change, 5.2+/-1.7 D). Patients with preoperative astigmatism <6.0 D (3.4+/-0.2 D; n = 5) were found to have an insignificant increase in astigmatism after surgery (astigmatism change, 0.0+/-0.6 D). After surgery, significant corneal opacity was found in 1 patient; mild bluish scleral hue was found in 3 patients. Surgical complications included prolonged reepithelialization, interface neovascularization, graft rejection, and steroid glaucoma.
Using full-thickness central corneal grafts in lamellar keratoscleroplasty for limbal dermoids achieved good cosmetic results with limited postoperative complications. Operation may markedly reduce corneal astigmatism in patients with high preoperative corneal astigmatism. Visual prognosis is good in patients undergoing surgery combined with adequate amblyopia treatment.
评估接受板层角膜巩膜移植联合中央全层角膜移植治疗角膜缘皮样瘤患者的手术效果。
回顾性、非对比性、对连续病例系列进行图表回顾分析。
1992年至2003年期间在台湾大学医院接受板层角膜巩膜移植联合中央全层角膜移植治疗10例角膜缘皮样瘤患者（10只眼），其中男性6例，女性4例；平均年龄12.3±5.0岁（范围5.7 - 22.4岁）。
回顾病历及眼部外观照片。
将最佳矫正视力（BCVA）、角膜散光及地形图、美容效果和手术并发症作为观察指标。为分析手术对角膜散光的影响，将9例有地形图数据的患者按术前角膜散光情况分为2组（1组：≥6屈光度[D]；2组：＜6 D）。
最早记录的平均BCVA和术后最晚BCVA分别为6/30和6/10，术后联合弱视治疗后BCVA在斯内伦视力表上提高了4.9±3.6行。术前散光≥6.0 D的患者（9.7±1.0 D；n = 4）术后散光明显降低（散光变化5.2±1.7 D）。术前散光＜6.0 D的患者（3.4±0.2 D；n = 5）术后散光增加不明显（散光变化0.0±0.6 D）。术后1例患者出现明显角膜混浊；3例患者巩膜轻度发蓝。手术并发症包括上皮化延迟、界面新生血管形成、移植排斥反应和类固醇性青光眼。
在板层角膜巩膜移植治疗角膜缘皮样瘤中使用中央全层角膜移植可获得良好的美容效果，术后并发症有限。手术可显著降低术前角膜散光高的患者的角膜散光。手术联合适当弱视治疗的患者视力预后良好。
