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[深板层角膜移植术与穿透性角膜移植术治疗真菌性角膜溃疡的视觉功能疗效]

[The visual functional therapeutic effects of deep lamellar keratoplasty and penetrating keratoplasty for fungal corneal ulcer].

作者信息

Lu Qin-kang, Tong Qi-hu, Lai Xiao-ming, Wang Hui-yun, Zhao Na

机构信息

Ophthalmology Center, Ningbo Yinzhou People Hospital, Ningbo 315040, China.

出版信息

Zhonghua Yan Ke Za Zhi. 2011 May;47(5):423-6.

PMID:21756744
Abstract

OBJECTIVE

To investigate the visual functional therapeutic effects of deep lamellar keratoplasty (DLK) and penetrating keratoplasty (PK) on perforated fungal keratitis.

METHODS

64 patients (64 eyes) of fungal corneal ulcer in Ophthalmology Center of Ningbo Yinzhou People Hospital from 2004 to 2009 were retrospected, of which undergo DLK (36 patients, 36 eyes) and PK (28 patients, 28 eyes), and followed up by 12 to 24 months. Check two sets of patients' VA and refraction before operation, and analyze the best-corrected visual acuity (BCVA), corneal refraction changes, corneal endothelium counting and complications, using χ(2) test and t-test.

RESULTS

The BCVA after the operation of two sets are both improved, 32 eyes of DLK set were above 0.4, 19 eyes of PK set were above 0.4, of which the DKL set is a bit better than PK set (χ(2) = 4.304, P > 0.05). The astigmatism of DLK set is smaller than the PK set after operation, and there is significant difference (χ(2) = 4.98, P < 0.05). The astigmatism of two sets on the average were all no more than 5.00 D. The reject reaction of keratoplasty of DLK is less than PK, there is obviously significant difference (χ(2) = 34.17, P < 0.05).

CONCLUSIONS

There is less complications of DLK than PK for fungal corneal ulcer. DLK can reduce the occurrence of reject reaction of endothelium type, and the BCVA, refraction of DLK after operation is similar to PK, the incidence rate of surgical operation failure is low.

摘要

目的

探讨深板层角膜移植术(DLK)与穿透性角膜移植术(PK)治疗真菌性角膜溃疡穿孔的视觉功能疗效。

方法

回顾性分析2004年至2009年宁波市鄞州人民医院眼科中心64例(64眼)真菌性角膜溃疡患者,其中行DLK者36例(36眼),行PK者28例(28眼),随访12至24个月。检查两组患者术前视力和屈光状态,分析最佳矫正视力(BCVA)、角膜屈光变化、角膜内皮细胞计数及并发症情况,采用χ²检验和t检验。

结果

两组术后BCVA均提高,DLK组32眼BCVA高于0.4,PK组19眼BCVA高于0.4,其中DLK组略优于PK组(χ² = 4.304,P > 0.05)。术后DLK组散光小于PK组,差异有统计学意义(χ² = 4.98,P < 0.05)。两组平均散光均不超过5.00 D。DLK角膜移植排斥反应少于PK组,差异有显著统计学意义(χ² = 34.17,P < 0.05)。

结论

真菌性角膜溃疡采用DLK治疗并发症少于PK。DLK可减少内皮型排斥反应的发生,术后BCVA、屈光状态与PK相似,手术失败发生率低。

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