角膜移植术后排斥反应的防治探讨

Preventive treatment of the rejection after keratoplasty

目的:为控制角膜移植术后发生排斥反应,探讨防治排斥反应的有效途径。方法:对73例73眼穿透性角膜移植术患者术后排斥反应发生率进行回顾性分析。结果:患者73眼中28眼发生免疫排斥反应(38%),其中高危角膜病变21眼,非高危角膜病变7眼,有角膜新生血管者占88%,排斥反应发生时间为术后2wk～3a,以内皮型排斥反应为主(43%)。经药物联合治疗,角膜排斥反应得到明显抑制,有效率达61%。结论:高危角膜病变免疫排斥反应几率明显增加,发生时间及持续时间较长,因此应根据不同角膜病变在术前、术中、术后采取相应措施减少排斥反应发生率。

AIM：To discuss the approach of prevention for the rejection after keratoplasty·METHODS：A retrospective analysis of the rate of rejection in 73 patients（73 eyes） was made after penetrating keratoplasty·RESULTS：The immunological rejection happened in 28 eyes（38%）,consisting of 21 eyes with high risk keratopathy and 7eyes with non high risk keratopathy,corneal neovascularization took up 88%.The immunological rejection happened in 2 weeks to 3 years after keratoplasty.The corneal endothelium rejection occupied 43%.The immunological rejection were restrained after medication obviously,the effective percentage was 61%·CONCLUSION：The rate of rejection is markedly increased in eyes with high risk keratopathy,which persists long time.We should take measures before,during and after keratoplasty based on different keratopathy.