Chen Wei, Li Guo-xing, Wang Qin-mei, Zhao Yun-e, Qu Jia
The Affiliated Eye hospital of Wenzhou Medical School, Wenzhou 325003, China.
Zhonghua Yan Ke Za Zhi. 2005 Nov;41(11):1000-4.
To evaluate the safety and efficacy of microkeratome-assisted lamellar keratoplasty (MLK) for the treatment of recurrent granular corneal dystrophy (GCD) after phototherapeutic keratectomy (PTK).
We performed a prospective study of nine eyes (seven patients) with recurrent granular dystrophy after PTK. A microkeratome was used to cut partial-thickness sections through the anterior surface of the donor and host corneas. The donor disc was placed on the recipient bed with four or eight interrupted sutures. The stitches were removed between 4 and 6 weeks after surgery. Visual acuity (VA), corneal clarity, corneal thickness, and corneal topography were assessed before and at different time points after surgery.
During a mean follow-up period of (18.9 +/- 4.1) months, all grafts were transparent without visible opacity at the interface, and no serious complications occurred. The VA was improved in all cases. seven eyes had best corrected visual acuity with spectacles of 20/40 or better, two eyes reached 20/25. At the last follow-up visit more than 12 months postoperatively, the mean corneal refractive power increased significantly by (2.34 +/- 0.93) D (P < 0.01), and the corneal astigmatism significantly decreased by (0.91 +/- 0.98) D (P < 0.05). The mean corneal thickness was (477.4 +/- 26.9) microm preoperatively and (507.8 +/- 23.4) microm at the last follow-up visit (P < 0.01).
Our findings suggest that MLK for the treatment of recurrent GCD is a safe and easy-to-perform method for restoring VA.
评估微型角膜刀辅助板层角膜移植术（MLK）治疗光治疗性角膜切削术（PTK）后复发性颗粒状角膜营养不良（GCD）的安全性和有效性。
我们对7例患者的9只眼进行了PTK后复发性颗粒状营养不良的前瞻性研究。使用微型角膜刀在供体和受体角膜前表面切取部分厚度的切片。将供体角膜片置于受体床上，用4或8针间断缝合。术后4至6周拆除缝线。在手术前和术后不同时间点评估视力（VA）、角膜清晰度、角膜厚度和角膜地形图。
在平均（１８.９±４.１）个月的随访期内，所有移植片均透明，界面无可见混浊，未发生严重并发症。所有病例的视力均有改善。7只眼戴眼镜的最佳矫正视力达到20/40或更好，2只眼达到20/25。术后12个月以上的最后一次随访时，平均角膜屈光力显著增加（2.34±0.93）D（P<0.01），角膜散光显著降低（0.91±0.98）D（P<0.05）。术前平均角膜厚度为（477.4±26.9）μm，最后一次随访时为（507.8±23.4）μm（P<0.01）。
我们的研究结果表明，MLK治疗复发性GCD是一种恢复视力的安全且易于实施的方法。
