穿透性角膜移植术后移植片的转归

The change of graft opacity after penetrating cornea transplanation

目的 探讨穿透性角膜移植术后移植片的转归 ,分析移植片混浊的原因 ,为预防和治疗提供依据。方法 回顾性分析 45 0例 (4 5 6只眼 )穿透性角膜移植术 ,追踪观察半年～ 10年 ,分析角膜移植片混浊原因。结果 发现在 45 6只眼中 ,角膜移植片透明 412只眼 ,透明成功率 90 .4%。发生角膜混浊 44只眼 ,其中继发性青光眼 3只眼 ,占 0 .6 5 % ;排斥反应 2 8只眼 ,占 6 .2 % ;病灶复发 9只眼 ,占 1.96 % ;供眼角膜内皮细胞损伤 4只眼 ,占 0 .8%。结论 早期角膜移植片混浊的主要原因为供眼角膜内皮细胞损伤及继发性青光眼 ;中晚期混浊的主要原因为排斥反应和病灶复发。认为术中预防供眼角膜内皮损伤 。

Objective To analyse the change of graft opacity after penetrating cornea transplanation and provide basis for prevention and treatment.Methods We have retrospective survey studied 450 cases,Among them,the shortest is half year and the longest is ten years after penetrating cornea transplanation,To understand the cause of graft opacity.Results We found amond 456 eyes,transparent graft is 412 eyes(90.4%).opacity greyes.Among that 44 eyes,second glaucoma 3 eyes(0.65%),reject reaction 28 eyes(6.2%),focus recurrence 9 eyes(1.96%).The donor eye's endoepithelium damage 4 eyes(0.8%).Conclusions The main cause of early graft are donor eye's endoepithelium damage and second glaucoma.The cause of later graft opacity are reject reaciton and focus recurrence.We think that it is the key of preventing graft opacity to void the donor eye's endoepithelium damage during the operation and try to fing out and treat the reject reaction and focus recurrence early.