角膜移植术后行白内障摘出人工晶状体植入对角膜植片的影响

Phacoemulsification with intraocular lens implantation in treatment for cataract after penetrating keratoplasty

目的探讨穿透性角膜移植术后白内障行白内障摘出联合人工晶状体植入术对角膜植片的影响。方法穿透性角膜移植术6个月后行白内障摘出联合人工晶状体植入术17例(17眼),随访3～18个月,平均11个月,观察术后角膜水肿情况、角膜内皮细胞计数变化、眼压变化、免疫排斥反应和术后并发症,并进行分析。结果术后所有患眼裸眼视力≥0.3,最佳矫正视力≥0.5者8眼。术后角膜水肿3～7d内消退,角膜恢复透明。术前角膜内皮计数平均为(1547±111)个/mm2。术后3月内皮细胞数量稳定,平均为(1275±106)个/mm2,内皮细胞丧失率平均为4.92%。无其它不良反应。结论对穿透性角膜移植术后行白内障摘出联合人工晶状体植入术对角膜植片是安全的。

Objective To dieuss the influencing of phacoemulsifieation with IOL implantation on endothelial cells of eorenal graft, which was perfomed for cataract after penetrating keratoplasty. Method Phaeoemulsifieation with IOL implantation were perfomed on 17 eases （17eyes） of cataract after penetrating ketatoplasty. The corneal edema, corneal endothelial cell counting, intraocular pressure, corneal graft rejecting and postoperative complications were observed. All the patients had been followed up for 3 -18 months, meanly 11 months. Results The postoperative best corrected vision was no less than 0.5 in 8 eyes. The postoperative uncorrected vision was no less than 0.3 in all of the eyes. Corneal edema disappeared in 3 -7 days after eperation. Endothelial cells density before operation was （ 1547 ±111 ）/mm2, and （ 1275 ±106）/mm2 3months after operation. The average endothelial cell loss rate was 4.92%. Conclusion Phaeoemulsifieation is safe and effective for cataract after penetrating ketatoplasty.