板层角膜移植联合睑缘缝合术对植片溶解的影响

The Effect of Lamellar Keratoplaety Combined with Tarsorrhaphy on Graft Dissolution

目的探讨角膜移植术后行睑缘缝合术对防止植片溶解的作用.方法回顾性分析2004年1月至2007年6月54例角膜病变患者,共61只眼.其中29只眼行板层角膜移植联合暂时性睑缘缝合术,余32只眼仅行单纯板层角膜移植术.术后随访1周～12月,平均(7±2)月,观察角膜植片上皮生长情况、有无植片溶解、排斥反应及角膜植片的透明度.结果行单纯角膜板层移植术的32只眼有16只眼(50%)上皮长入不良,植片溶解,2只眼(7%)发生排斥反应.于角膜板层移植术后行睑缘缝合术29只眼拆除缝线后,5只眼(17.2%)有植片溶解发生,两组比较差异有统计学意义(P<0.05).再行长期睑缘缝合术后无植片溶解发生,余患眼中1只眼(3%)发生排斥反应.结论板层角膜移植术后行眼睑缝合术是预防和减少植片溶解发生的有效方法.

Objective To disseuss the effect of lamellar keratoplaety combined with tarsorrhaphy on graft dissolution. Methods Fifty-four patients （61 eyes ） with corneal disease who underwent lamellar keratoplaety in our department between January 2004 and June 2007, were retrospectively analyzed, including 29 eyes performed lamellar keratoplaety combined with tarsorrhaphy and 32 eyes performed lamellar keratoplaety only. The follow-up period was 1 week to 12 months with an average of （7 ± 2） months. The growing situation of corneal craft epithelium, does the graft dissolution or not, rejection and the transparency of corneal graft were observed. Results 32 eyes received lamelar keratoplaety in which corneal epithelium didn＇t grow well and then the graft dissolved in 16 eyes （50%）, rejection occurred in 2 eyes （7%）. 29 eyes received lamellar combined with tarsorrhaphy in which graft dissolution occurred in 5 eyes （17.2%） （P 〈 0.05） and rejection occurred in l eyes （3%）. After performed transparency, the 5 dissolution eyes didn＇t have graft dissolution any more. Conclusion Lamellar keratoplaety combined with tarsorrhaphy is an effective way to prevent graft dissolution.