Agrawal V, Vagh M M, Sangwan V, Rao G N
Sight Savers' Cornea Training Centre, L.V. Prasad Eye Institute, Hyderabad.
Indian J Ophthalmol. 1994 Jun;42(2):75-80.
Penetrating keratoplasty (PK) is the only definitive treatment for the visual rehabilitation of eyes with pseudophakic bullous keratopathy (PBK). Management of the intraocular lens (IOL) at the time of PK is dependent on lens-related factors and anterior segment abnormalities. We reviewed the results of PK in 81 cases of PBK done at our institute between November 1987 and May 1993. The original lens was an anterior chamber IOL in 26 (32.1%) eyes, iris claw lens in 38 (41.9%) eyes, and a posterior chamber IOL in 17 (20.98%) eyes. IOL explanation alone was done in 24 (29.6%) eyes. The original IOL was retained in 12 (14.9%) eyes and IOL exchange was done in 45 (55.5%) eyes. With a minimum follow-up period of 6 months, the graft remained clear in 54 (66.6%) and the commonest cause of graft failure was graft rejection (17.2%). The best-corrected visual acuity in our series was 20/40 or more in 11 (20.3%) eyes and 20/50 to 20/100 in 30 (55.5%) eyes. We recommend explantation of all closed-loop anterior chamber and iris claw IOLs, and that, anterior chamber reconstruction during PK IOL exchange should be done using a posterior chamber IOL or open-loop Kelman type AC IOL.
穿透性角膜移植术（PK）是治疗假晶状体大泡性角膜病变（PBK）眼视力恢复的唯一确定性治疗方法。PK手术时人工晶状体（IOL）的处理取决于与晶状体相关的因素和眼前节异常情况。我们回顾了1987年11月至1993年5月在我院进行的81例PBK患者的PK手术结果。原晶状体为前房型IOL的有26只眼（32.1%），虹膜爪型晶状体的有38只眼（41.9%），后房型IOL的有17只眼（20.98%）。仅进行IOL取出的有24只眼（29.6%）。保留原IOL的有12只眼（14.9%），进行IOL置换的有45只眼（55.5%）。随访期至少6个月，54只眼（66.6%）的植片保持透明，植片失败最常见的原因是植片排斥反应（17.2%）。我们系列病例中最佳矫正视力在20/40或更好的有11只眼（20.3%），20/50至20/100的有30只眼（55.5%）。我们建议取出所有闭环前房型和虹膜爪型IOL，并且在PK手术IOL置换时，眼前节重建应使用后房型IOL或开环Kelman型前房型IOL。
