Nobe J R, Moura B T, Robin J B, Smith R E
Doheny Eye Institute, Los Angeles, CA 90033.
Arch Ophthalmol. 1990 Jul;108(7):939-41. doi: 10.1001/archopht.1990.01070090041035.
We retrospectively analyzed 46 consecutive cases of penetrating keratoplasty performed as part of the treatment of corneal perforations; the minimum follow-up time after keratoplasty was 7 months. Predisposing conditions leading to perforation were an infectious keratitis in 26 eyes (57%), trauma in 14 eyes (30%), and corneal melt associated with ocular surface disorder in 6 eyes (13%). The success of penetrating keratoplasty in the treatment of corneal perforation depended on the timing of surgery and the cause of the perforation. If the perforation was traumatic in origin, delaying surgery for at least 3 months significantly improved the chances for graft success. Eighty percent of the penetrating keratoplasties delayed 3 months following primary repair of corneal laceration remained clear, and 50% of these patients had a visual acuity of 20/60 or better. If penetrating keratoplasties were performed for an infectious corneal perforation, grafts had a better chance to remain clear if surgery could be delayed. All grafts performed for corneal perforation associated with melting and ocular surface abnormalities failed.
我们回顾性分析了46例作为角膜穿孔治疗一部分而进行的穿透性角膜移植连续病例；角膜移植术后的最短随访时间为7个月。导致穿孔的诱发因素包括26眼（57%）的感染性角膜炎、14眼（30%）的外伤以及6眼（13%）与眼表疾病相关的角膜溶解。穿透性角膜移植治疗角膜穿孔的成功取决于手术时机和穿孔原因。如果穿孔源于外伤，将手术推迟至少3个月可显著提高移植成功的几率。在角膜裂伤一期修复后推迟3个月进行的穿透性角膜移植中，80%的移植片保持透明，其中50%的患者视力达到20/60或更好。如果因感染性角膜穿孔进行穿透性角膜移植，若能推迟手术，移植片保持透明的机会更大。所有因与角膜溶解和眼表异常相关的角膜穿孔而进行的移植均失败。
