新生儿供体角膜大桥状穿透性角膜移植的实验和临床应用

Experiments and clincal application of“bigbridged”penetrating keratoplasty by using newborn donor corneas

目的减轻新生儿供体角膜穿透性角膜移植术后的近视程度。方法推导出应用新生儿供体角膜时植片直径与值床直径关系的矫正公式以缩小植片，采用大桥状穿透性角膜移植术式以增加植片抗张力。用角膜屈光度测量、光镜组织学、角膜内皮细胞检查等方法，进行了50只家兔眼的对比观察，并临床应用13例。结果术后180d实验组角膜屈光度为49.11±4.72D，对照组为60.00D。13例病人平均随访8.96mo，植片平均屈光度47.90D，验光近视-1.00～－8.00D，平均－3.75D。结论缩小植片联合大桥状穿透性角膜移植术式可减轻新生儿供体角膜穿透移植术后的高度近视。

Objective To miniimize the severity of postoperative myopia after penetrating keratoplasty by using newborn donor corneas.Methods In order to minimize the size of the graft,we deduce the correcting formula of the relationship between the diamesters of the graft and the recipient bed during the application of the 'big-bridged' penetrating keratoplasty by using newborn donor corneas. The constructive methods were introduced to 50 rabbits' eyes by means of light microscope histology. corneal endothelium examination and corneal refraction determination, and then those improved methods were applied to 13 patients.Results Six months after the operation, the mean corneal refraction of the patients was 49. 11±4. 72D in theexperimental group, while it was 60. 00D in the contral group. The mean graft refraction of 13 patients (who werefollowed up for 8. 96 months) was 47. 90D. The optometric result was-1. 00-8. 00D (mean: -3. 75D).Conclusion The ' big-bridged' penetrating keratoplasty combined with minimized graft can basically prevent the severe postoperative myopia with newborn donor corneas.