穿透性角膜移植术治疗人工晶状体眼性角膜水肿
Penetrating keratoplasty for pseudophakic corneal oedema.
作者信息
Kwartz J, Leatherbarrow B, Dyer P, Ridgway A E, Tullo A B
机构信息
Manchester Royal Eye Hospital.
出版信息
Br J Ophthalmol. 1995 May;79(5):435-8. doi: 10.1136/bjo.79.5.435.
AIMS
The study was designed to investigate the results of penetrating keratoplasty (PK) for pseudophakic corneal oedema (PCO).
METHODS
Retrospective analysis of 80 consecutive patients (82 eyes) who underwent PK for PCO between the years 1980-1992 with a minimum follow up of 12 months.
RESULTS
PKs for PCO have accounted for as many as 20% of all grafts performed in the hospital in recent years. The interval between cataract extraction and PK ranged from 6 to 161 months (mean 51 months). The intraocular lens was removed in 45 (55%), left in situ in 30 (37%), and exchanged in seven (8%) of cases respectively. Of the intraocular lenses involved 62% were iris supported, 31% angle supported, and 7% were posterior chamber lenses. Actuarial analysis shows graft survival to be 91% at 1 year and 86% at 2 years after surgery. The likelihood of graft survival was significantly enhanced by removal of the intraocular lens (p < 0.01). A corrected Snellen visual acuity worse than 6/60 was present in 36% of patients with a clear corneal graft. Ocular comfort was achieved in all patients with a clear corneal graft.
CONCLUSION
PK for PCO resulted in a disappointing visual result in a large proportion of patients. PK was, however, successful in relieving pain and corneal ulceration when present.
目的
本研究旨在调查穿透性角膜移植术（PK）治疗人工晶状体性角膜水肿（PCO）的效果。
方法
回顾性分析1980年至1992年间连续80例（82只眼）因PCO接受PK治疗且随访至少12个月的患者。
结果
近年来，因PCO进行的PK手术占该医院所有移植手术的20%。白内障摘除与PK之间的间隔时间为6至161个月（平均51个月）。分别有45例（55%）患者的人工晶状体被取出，30例（37%）留在原位，7例（8%）进行了更换。所涉及的人工晶状体中，62%为虹膜支撑型，31%为房角支撑型，7%为后房型。精算分析显示，术后1年移植片存活率为91%，2年为86%。取出人工晶状体可显著提高移植片存活的可能性（p<0.01）。36%角膜移植片透明的患者矫正视力低于6/60。所有角膜移植片透明的患者眼部舒适度良好。
结论
PK治疗PCO在很大一部分患者中导致了令人失望的视力结果。然而，PK在缓解疼痛和角膜溃疡方面是成功的。
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