保留人工晶状体的穿透性角膜移植术

The study of retaining intraocular lens during penetrating keratoplasty

目的探讨人工晶状体眼行穿透性角膜移植术时,保留人工晶状体的方法。方法人工晶状体术后16例(16只眼),合并有大泡性角膜病变11只眼,角膜白斑5只眼。采用角膜缘双针固定人工晶状体方法 ,再常规行穿透性角膜移植术,处理原人工晶状体并发症。结果 16例(16只眼)保留人工晶状体,术中人工晶状体固定平稳,2只眼行人工晶状体位置调整,2只眼剪除人工晶状体前膜。术后随访6～18个月,平均(11.2±2.3)个月,矫正视力0.2～0.5者14只眼,占87.5%,角膜保持透明15只眼,占93.7%,所有术眼前房正常。结论人工晶状体眼行穿透性角膜移植时,双针固定人工晶状体,对保留原人工晶状体、处理原人工晶状体并发症、减少植片内皮细胞损失、保持植片透明、恢复视力,是一种简便易行的较好的辅助手术方法 。

Objective To study the method of retaining intraocular lens in the pseudophakie eyes during penetrating keratoplasty. Methods 16 eyes of 16 patients were implanted intraocular lens, 11 eyes with bullous keratopathy, 5 eyes with keratoleukoma , intraocular lens were fixed with two long-needle through the limbns, and then the penetrating keratoplasty were routinely operated on the pseudophakic eyes, at the same time, the complications of intraocular lens were dealt with. Results During penetrating keratoplasty, intraocular lens were stably fixed and retained in 16 eyes of 16 cases, intraocular lens position were adjusted in 2 eyes. lntraocular lens anterior membrane were cut off in 2 eyes. Postoperative follow-up 6 -18 months, mean 11.2 ± 2.3 months, there were 14 eyes （ 87.5% ） of the corrected vision acuity ranged from 0. 2 to 0.5, 15 eyes （93.7% ） of the remained clear corneal graft , and normal anterior chamber in all cases. Conclusion When penetrating keratoplasty in the pseudophakic eyes, it is a simple and easy good auxiliary surgical techniques to retain IOL fixed with two long-needle through the limbus, deal with the complications of IOL, reduce corneal graft endothelial cell loss, maintain corneal graft transparency and restore vision.