Zhou Ping, Yao Yu-feng, Qiu Wen-ya, Zhang Yong-ming, Zhang Bei
Department of Ophthalmology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China.
Zhonghua Yan Ke Za Zhi. 2005 Dec;41(12):1103-6.
To observe and evaluate secondary optical penetrating keratoplasty (PKP) in the eyes with severe keratomycosis after therapeutic keratoplasty using cryopreserved donor tissue.
There were 35 eyes in 35 cases for whom therapeutic PKP using cryopreserved donor tissue had been carried out to treat severe fungal keratitis. At least 6 months after the PKP, when the fungal infection had been eradicated and ocular inflammation had resolved, a secondary optical penetrating keratoplasty was further performed for visual rehabilitation. If the crystal lens was found to be opaque, it was also simultaneously removed through extracapsular cataract removal with an IOL implantation. Surgical or postoperative complications, visual outcome, graft rejection episode, and graft survival were analyzed.
Among 35 eyes, 18 eyes received optical PKP only, and 17 received combined optical PKP with ECCE and IOL implantation. During the follow-up period of 6.8 - 36.8 (15.7 +/- 7.6) months after optical PKP, 3 eyes experienced graft failure due to immunologic rejection and 32 retained clear grafts. Postoperative visual acuity was 0.4 or better in 24 eyes, and 0.1 or better in 32 eyes, and less than 0.1 in 3 eyes.
Optical PKP performed in the eyes after therapeutic PKP due to severe fungal keratitis can recover satisfactory visual acuity, with low frequency of graft rejection, long-term graft survival and few complications.
观察和评估使用冷冻保存供体组织在治疗性角膜移植术后的严重角膜真菌病眼中进行二期光学穿透性角膜移植术(PKP)的效果。
35例患者共35只眼,采用冷冻保存供体组织进行治疗性PKP以治疗严重真菌性角膜炎。PKP术后至少6个月,当真菌感染已根除且眼部炎症消退后,进一步行二期光学穿透性角膜移植术以恢复视力。若发现晶状体混浊,则同时通过白内障囊外摘除联合人工晶状体植入术将其摘除。分析手术或术后并发症、视力结果、移植物排斥反应及移植物存活情况。
35只眼中,18只眼仅接受了光学PKP,17只眼接受了光学PKP联合白内障囊外摘除及人工晶状体植入术。在光学PKP术后6.8 - 36.8(15.7±7.6)个月的随访期内,3只眼因免疫排斥反应导致移植物失败,32只眼移植物保持透明。术后24只眼视力达到0.4或更好,32只眼视力达到0.1或更好,3只眼视力低于0.1。
在因严重真菌性角膜炎行治疗性PKP后的眼中进行光学PKP可恢复令人满意的视力,移植物排斥反应发生率低,移植物长期存活且并发症少。