Melbourne University Department of Ophthalmology, Centre for Eye Research Australia, University of Melbourne, Australia.
Cornea. 2011 Feb;30(2):171-4. doi: 10.1097/ICO.0b013e3181ead943.
Evaluation of "tuck in" lamellar keratoplasty (TILK) for the surgical management of postkeratoplasty corneal ectasia with peripheral corneal involvement.
Four eyes of 3 patients with post-penetrating keratoplasty corneal ectasia and contact lens intolerance underwent TILK that included a central lamellar keratoplasty with intrastromal tucking of the peripheral flange, at the Royal Victorian Eye and Ear Hospital, Melbourne, Australia. The main outcome measures analyzed were uncorrected visual acuity, best-corrected visual acuity, keratometry, and endothelial cell density.
The original indication for surgery was keratoconus in all the cases. TILK was successfully performed in these patients. Mean follow-up period was 13 months (SD: 7.74) (range: 6-24 months). The preoperative best-corrected visual acuity improved from a mean value of 0.05 (SD: 0.05) to 0.34 (SD: 0.03) (P < 0.001). Mean keratometry decreased from 59.67 diopter (SD: 7.18) preoperatively to 43.50 diopter (SD: 2.23) postoperatively (P < 0.005). Mean endothelial cell loss after TILK was 5.93% (SD: 3.06) (P < 0.206). All grafts were clear at the last follow-up, and no cases of stromal or endothelial graft rejection were encountered.
TILK can be successfully performed for post-penetrating keratoplasty corneal ectasia with peripheral corneal thinning.
评估“内卷式”板层角膜移植术（TILK）治疗伴有周边角膜受累的穿透性角膜移植术后角膜扩张的效果。
在澳大利亚墨尔本皇家维多利亚眼耳医院，对 3 例穿透性角膜移植术后角膜扩张伴接触镜不耐受的患者的 4 只眼行 TILK 治疗，该手术包括中央板层角膜移植术，周边边缘行基质内内卷。主要观察指标为未矫正视力、最佳矫正视力、角膜曲率计和角膜内皮细胞密度。
所有病例的最初手术指征均为圆锥角膜。这些患者均成功完成了 TILK。平均随访时间为 13 个月（标准差：7.74）（范围：6-24 个月）。术前最佳矫正视力从平均 0.05（标准差：0.05）提高至 0.34（标准差：0.03）（P<0.001）。术前平均角膜曲率计从 59.67 屈光度（标准差：7.18）下降至术后的 43.50 屈光度（标准差：2.23）（P<0.005）。TILK 后平均内皮细胞丢失 5.93%（标准差：3.06）（P<0.206）。末次随访时所有移植物均透明，未发生任何基质或内皮移植物排斥反应。
TILK 可成功治疗伴有周边角膜变薄的穿透性角膜移植术后角膜扩张。
