新型软性一体式聚甲基丙烯酸羟乙酯角膜假体植入碱烧伤兔角膜的研究
[The study of new soft one-piece PHEMA keratoprosthesis implanted into alkali burned rabbits cornea].
作者信息
Bai Hua, Huang Yi-fei, Wang Li-qiang
机构信息
Department of Ophthalmology, PLA General Hospital, Beijing 100853, China.
Email:
出版信息
Zhonghua Yan Ke Za Zhi. 2013 Oct;49(10):909-13.
OBJECTIVE
This study was to evaluate clinical results of two types soft one-piece keratoprosthesis (KPros) made of PHEMA implanted to alkali burned rabbit corneas.
METHODS
Experimental study. Twelve pieces KPros were implanted alkali burned rabbit corneas(type I and II, 6 pieces respectively). The examinations including slit-lamp, fundus photography,B-ultrasound and ultrasound biomicroscopy (UBM) were carried out.
RESULTS
All Kpros were stable and no complications happened including conjunctiva flap dehiscence, aqueous leak and infection. IOP were normal by finger touch. B-ultrasound show no retina detachment and UBM show synechia in most animals (10 case). Retroprosthetic membrane happened in type I (3 case) . Visible conjunctiva hyperplasia covering the optical region happened in all KPros.
CONCLUSIONS
(1) The same material, integrated design, maybe eliminating the material interface problem. (2)Simple surgical skills. (3)IOP measurement is possible because of soft material. (4)KPro I do not need removal of the lens and vitrectomy. The projecting portion of KPro II may reduce the incidence of proliferative membrane. Long term effects need more cases and further observation.
目的
本研究旨在评估两种由聚甲基丙烯酸羟乙酯（PHEMA）制成的一体式软性角膜假体（KPro）植入碱烧伤兔角膜后的临床效果。
方法
实验研究。将12片KPro植入碱烧伤兔角膜（I型和II型各6片）。进行了裂隙灯、眼底照相、B超和超声生物显微镜（UBM）检查。
结果
所有KPro均稳定，未发生包括结膜瓣裂开、房水渗漏和感染等并发症。通过指测眼压正常。B超显示无视网膜脱离，UBM显示大多数动物（10例）有粘连。I型发生了人工晶状体后膜（3例）。所有KPro均出现可见的结膜增生覆盖光学区。
结论
（1）相同材料、一体化设计，可能消除材料界面问题。（2）手术技巧简单。（3）由于材料柔软，眼压测量可行。（4）I型KPro无需取出晶状体和进行玻璃体切除术。II型KPro的突出部分可能降低增殖膜的发生率。长期效果需要更多病例和进一步观察。
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