Cung Le Xuan, Hang Do Thi Thuy, Hiep Nguyen Xuan, Quyet Do, Thai Than Van, Nga Vu Thi, Bac Nguyen Duy, Nguyen Dinh Ngan
Vietnam National Institute of Ophthalmology, Hanoi, Vietnam.
Vietnam Military Medical University (VMMU), Hanoi, Vietnam.
Open Access Maced J Med Sci. 2019 Dec 20;7(24):4301-4305. doi: 10.3889/oamjms.2019.379. eCollection 2019 Dec 30.
Cataract is one of the reasons which causes impaired visual acuity (VA) of the eyes after penetrating keratoplasy (PK), which can be treated by cataract surgery after PK or triple procedure. Cataract surgery after PK has advantages that parameters of the eyes such as axial length, anterior chamber depth (ACD) as well as corneal curvature are stabilized after removing all sutures postoperatively, and intraocular lens (IOL) power can be calculated correctly. Therefore, postoperative VA will be improved significantly. In Vietnam, there have not been any study about cataract surgery after PK, therefore we conduct this research.
To evaluate the outcomes of phacoemulsification cataract surgery following primary PK.
Non-randomized controlled intervention study. Ninteen eyes (19 patients) that underwent phacoemulsification plus IOL insertion after initial PK in Cornea department, Vietnam National Institute of Ophthalmology, from December 2013 to September 2014.
All patients presented with reduced VA, including 17 eyes (89.9%) with VA ≤ 20/200, mean astigmatism was 7.9 ± 1.0 D. Clear corneal grafts in 16 eyes while corneal opacity was seen in 3 eyes. All eyes with cataract were diagnosed from grade 2. After cataract surgery, improved VA > 20/200 was achieved in 72.22% of cases. There was a markable reduce of postoperative astigmatism with 1.8 ± 0.8 D (p < 0.05). However, the immunologic graft reaction was presented in one eye, and two edematous corneas also reported after cataract surgery. After treatment, there was one cornea achieved its clarity.
Phacoemulsification cataract surgery following initial PK showed good outcomes with improved postoperative VA, reduced astigmatism, and the ultimate graft survival rate was high.
白内障是穿透性角膜移植术（PK）后导致视力受损的原因之一，可通过PK术后的白内障手术或三联手术进行治疗。PK术后的白内障手术具有以下优势：术后拆除所有缝线后，眼轴长度、前房深度（ACD）以及角膜曲率等眼部参数得以稳定，人工晶状体（IOL）的度数能够准确计算。因此，术后视力将得到显著改善。在越南，尚未有关于PK术后白内障手术的研究，故而我们开展此项研究。
评估初次PK后超声乳化白内障手术的效果。
非随机对照干预研究。2013年12月至2014年9月期间，越南国家眼科研究所角膜科对19例患者的19只眼进行了初次PK后超声乳化联合人工晶状体植入术。
所有患者均存在视力下降，其中17只眼（89.9%）视力≤20/200，平均散光为7.9±1.0 D。16只眼角膜植片透明，3只眼角膜混浊。所有白内障眼均诊断为2级。白内障手术后，72.22%的病例视力提高至>20/200。术后散光显著降低，为1.8±0.8 D（p<0.05）。然而，有1只眼出现免疫性植片反应，白内障手术后还报告了2只眼角膜水肿。经治疗后，有1只眼角膜恢复透明。
初次PK后的超声乳化白内障手术效果良好，术后视力提高，散光降低，最终植片存活率高。
