圆锥角膜深板层角膜移植术后高度散光的角膜楔形切除术

Corneal wedge resection in treating progressive keratoconus astigmatism after deep anterior lamellar keratoplasty

目的分析圆锥角膜深板层角膜移植术后高度散光行角膜楔形切除的临床疗效。方法回顾性分析了圆锥角膜深板层角膜移植术后继发较高度散光的6例（6眼），采用对称或不对称的受体角膜植床组织楔形切除的方法治疗。随访内容为：裸眼视力、电脑验光结果、最佳矫正视力、角膜地形图结果。结果术后3年，矫正视力由术前的0．62±0．16，增加到0．73±0．16（P〉0．05）。K散光由术前的（8．37±2．91）D，减低到（2．86±2．06）D（P〈0．01）。所有病例均能接受佩戴框架眼镜。结论角膜楔形切除是矫正圆锥角膜深板层角膜移植术后高度散光的有效方法。

Objective To investigate the clinical effect of corneal wedge resection to treat progres- sive keratoconus astigmatism after deep anterior lamellar keratoplasty （DALK）. Methods Six cases （6 keratoconus eyes） after DALK with progressive astigmatism were retrospectively analyzed. A pair of symmetric or asymmetric host tissue wedge resections were made on the host cornea on the border of the graft - host interface. Naked or best corrected visual acuity, compute assisted refractive power examination, corneal to- pography were followed up for 36 months. Results Three years after corneal wedge resection, best correc- ted visual acuity changed from 0.62 ＋0.16 before surgery to 0.73 ＋0.16 after surgery （P 〉0.05）. K value was progressed from 8.37 ±2.91 before surgery to 2.86 ± 2.06 after surgery （ P 〈0.01 ） . Frame glasses were accepted by all the cases at the end of following up period. Conclusion Corneal wedge resection is an effective method in treating progressive keratoconus astigmatism after DALK.