板层角膜移植术治疗基质型活动期单纯疱疹性角膜炎的临床价值

A prospective study on the clinical value of lamellar keratoplasty for stromal herpes simplex keratitis at the active stage

客观评估板层角膜移植术 (Lamellarkeratoplasty ,LKP)治疗基质型活动期单纯疱疹性角膜炎 (herpessimplexkeratitis ,HSK)的临床价值。方法 :对 71例 ( 71只眼 )HSK基质型活动期患者分两组 ,一组 ( 33例 )行LKP ,另一组 ( 38例 )行穿透性角膜移植术 (pene tratingkeratoplasty ,PKP) ,比较两组病人术后的疗效与并发症。结果 :LKP组术后在视力、角膜移植片排斥反应发生率、原发病复发率与内眼手术并发症发生率等方面均明显优于PKP组 (P <0 0 1)。结论 :在适应症范围内 ,成功的LKP具有清除病灶彻底、排斥反应发生率低、无内眼手术并发症等优点 ,是治疗基质型活动期HSK的理想方法。

Objective:To evaluate the clinical value of Lamellar keratoplasty (LKP) for stromal herpes simplex keratitis (HSK) at the active stage. Methods:In a prospective study,71 eyes of cases of the stromal HSK at the active stage were divided and treated with two kinds of surgical techniques.One group (33 cases) was performed lamellar keratoplasty (LKP);the others were as control group (38 cases) to be performed penetrating keratoplasty (PKP).The effects and complications of the two groups after surgery were compared. Results:The postoperative mean visual acuity of LKP group was better than that of PKP group (P<0 01).The rejection rate of grafts,the recurrent rate of the primary disease and the rate of the complications of the intraocular surgery in LKP group were lower than that in PKP group (P<0 01). Conclusions:In the scale of indications,successful LKP has the following advantages,thorough clearance of local lesion,strong anti rejection,no complications of intraocular surgery.The results have proved that LKP is the ideal choice for treating the stromal HSK keratitis the active stage.