深板层角膜移植术治疗角膜疾病的临床分析

Clinical analysis of deep lamellar keratoplasty for corneal disease

目的评价深板层角膜移植术治疗某些角膜疾病的临床疗效。方法回顾性分析我院16例（16眼）罹患角膜疾病但内皮细胞功能正常而行深板层角膜移植者，对所有病例随访6月-2年，观察术后视力、角膜移植片的透明性、角膜上皮完整性及术中术后并发症的情况。结果术后有7眼最佳矫正视力达0．4或0．4以上，5眼达0．1～0．3，4眼达0．05～0．1。角膜移植片透明者9眼，半透明者7眼。主要并发症为术中后弹力层微穿孔6眼，其中3眼术后形成植片轻度水肿，角膜层间少量积液；持续性上皮缺损2眼；真菌性角膜溃疡复发1眼，移植排斥反应1眼，经积极治疗，并发症得到控制，取得良好疗效。结论深板层角膜移植术治疗内皮功能正常的角膜疾病疗效确切，严格掌握手术适应证、提高手术技巧是提高手术成功率的关键。

Objective To evaluate the clinical therapeutic effects of deep lamellar keratoplasty （DLKP） for corneal disease. Methods 16 cases （16 eyes ） DLKP were analyzed and followed up from 6 months to 2 years. Postoperative visual acuity, clarity of graft, corneal epithelium and complications were observed. Results The best postoperative visual acuity better than or equal to 0.4 in were in 7 cases, 0. 1 - 0.3 were in 5 cases, 0.05 - 0.1 were in 4 eyes. The cornea was clarity in 9 cases and half clarity in 7 cases. The main complications were： descement membrane perforation in 6 cases, persistent corneal epithelium coloboma 2 cases, recurrent fungal keratitis 1 case and immune rejection on the graft 1 case. Conclusion The DLKP is effective for corneal diseases with normal endothelium, and it is important for successful surgery to master indications for surgery and improve the operative technique.