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[儿童角膜移植术]

[Keratoplasty in children].

作者信息

Stärk N, Schmitt H, Schmitt M

出版信息

Klin Monbl Augenheilkd. 1984 Mar;184(3):180-4. doi: 10.1055/s-2008-1054436.

Abstract

The authors report on indications, surgical techniques and results obtained in 37 children up to the age of 14 (42 eyes) on whom a total of 45 keratoplasties were performed. In 5 cases keratoplasties were performed on both eyes. The grafts remained clear in 26 eyes (58%); 8 grafts were moderately opaque and 11 (24%) were completely opaque. As expected, the best results were obtained in cases of keratoconus. The keratoplasties performed in late stages of herpetic keratitis with extensive corneal scarring and vascularization were a little less successful. Of 11 eyes thus treated, a final clear graft was achieved in 8. In cases with traumatic scars after severe eye injuries, the results were less satisfactory. The prognosis is poor in all severe dystrophic alterations of the cornea, and very bleak in the final stages of central abscess or ring abscess of the cornea. In a relatively high percentage, clear grafts contrast with poor postoperative visual acuity, which may be caused by a variety of complications. The most prominent complications were amblyopia, cataracta complicata and traumatica and aphakia. Thus, only 14 out of 26 eyes with clear grafts achieved a visual acuity in the range from 0.4 to 1.0.

摘要

作者报告了对37名14岁以下儿童(42只眼)进行的总共45次角膜移植手术的适应证、手术技术和结果。其中5例为双眼角膜移植。26只眼(58%)的移植片保持透明;8只移植片中度混浊,11只(24%)完全混浊。正如预期的那样,圆锥角膜患者取得了最佳效果。在疱疹性角膜炎晚期伴有广泛角膜瘢痕形成和血管化的情况下进行的角膜移植手术成功率稍低。在接受治疗的11只眼中,最终有8只实现了移植片透明。在严重眼外伤后有外伤性瘢痕的病例中,结果不太令人满意。在所有严重的角膜营养不良性改变中预后较差,而在角膜中央脓肿或环形脓肿的晚期预后非常暗淡。相当高比例的透明移植片与术后视力不佳形成对比,这可能由多种并发症引起。最突出的并发症是弱视、并发性白内障、外伤性白内障和无晶状体。因此,在26只移植片透明的眼中,只有14只眼的视力达到了0.4至1.0的范围。

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