Ehlers N, Andersen J
Department of Ophthalmology, Arhus University Hospital, Denmark.
Acta Ophthalmol (Copenh). 1987 Oct;65(5):516-20. doi: 10.1111/j.1755-3768.1987.tb07034.x.
In the period 1979-83 a total of 232 penetrating corneal transplantations were performed with organ culture preserved donor material. Forty-two operations were made à chaud for central corneal ulcerations. The results of these interventions are reported and discussed. The surgery presented no serious problems and on first post-operative day the anterior chamber was reformed in all cases, and pain was relieved. Patients were confined to bed only for 1 day. Graft deswelling was slightly retarded compared to planned surgery, but all functioning grafts obtained normal thickness. The overall graft survival rates after 6, 12 and 18 months were 66, 53 and 48%, respectively. For herpetic ulcers the survival after 18 months was 49% and for non-herpetic ulcers 47%. The grafts failed in all cases where it had been necessary to employ grafts of more than 10 mm. This latter group was comprised of the non-herpetic cases; were they excluded, the graft survival rate would increase to 60%. Among cases with a clear graft the median visual acuity after 18 months was 0.33 (range less than 0.1-0.67). Excluding cases with a non-corneal cause of visual reduction, the median visual acuity was 0.4 (range 0.33-0.67). It is concluded that grafting can be successfully employed in the treatment of central ulcers, as it not only restitutes tissue integrity, but also preserves useful vision.
1979年至1983年期间，共进行了232例穿透性角膜移植手术，供体材料采用器官培养保存。针对中央角膜溃疡进行了42例急诊手术。报告并讨论了这些干预措施的结果。手术未出现严重问题，术后第一天所有病例前房均重新形成，疼痛缓解。患者仅需卧床1天。与计划手术相比，植片消肿稍有延迟，但所有功能良好的植片均恢复正常厚度。6个月、12个月和18个月后的总体植片存活率分别为66%、53%和48%。对于疱疹性溃疡，18个月后的存活率为49%，非疱疹性溃疡为47%。在所有需要使用直径超过10毫米植片的病例中，植片均失败。后一组均为非疱疹性病例；若将其排除，植片存活率将增至60%。在植片清晰的病例中，18个月后的中位视力为0.33（范围小于0.1 - 0.67）。排除因非角膜原因导致视力下降的病例后，中位视力为0.4（范围0.33 - 0.67）。结论是，移植可成功用于治疗中央溃疡，因为它不仅能恢复组织完整性，还能保留有用视力。
