探讨穿透性角膜移植治疗严重基质坏死型单疱病毒性角膜炎的分析

Analysis of corneal transplantation on the treatment of severe necrotizing stromal keratitis

目的探讨严重基质坏死型单疱病毒性角膜炎(HSK)患者采取穿透性角膜移植治疗的效果。方法选择本院2013年2月-2016年2月接诊的严重基质坏死型单疱病毒性角膜炎患者28例作为研究对象,纳入研究对象有完整临床资料,签署知情同意书,均接受穿透性角膜移植术治疗,治疗完成后均予以1年以上随访,观察记录本组患者术前、术后最佳矫正视力情况,以及角膜移植片与移植床情况、随访1年排斥反应与病毒性角膜炎复发率,并对比分析。结果本组患者经手术治疗后,术后最佳矫正视力>0.5者明显多于术前(P<0.05);28例患者经手术治疗后,26例植床透明、1例病变累及周边角膜内皮面、1例轻度水肿;随访1年仅有1例发生排斥反应,但无病毒性角膜炎复发。结论穿透性角膜移植术治疗严重基质坏死型单疱病毒性角膜炎可取得不错的效果,能明显改善最佳矫正视力,而且排斥反应与复发率低,安全性高,值得借鉴。

Objective To investigate the effect of penetrating keratoplasty on the treatment of severe necrotizing stromal keratitis（HSK）. Methods 28 cases of patients diagnosed of severe necrotizing stromal keratitis in our hospital from February 2013 to February2016,were chosen as research objects. All cases had clinical data and signed informed consent, were treated with penetrating keratoplasty.Followed-up was done for more than one year. The best preoperative and postoperative corrected visual acuity, corneal graft, transplant bed, rejection reaction after one year follow-up and viral keratitis recurrence rate were observed and recorded. The results were analyzed comparatively. Results After surgical treatment, the best corrected visual acuity of patients was 0.5 which was significantly higher than before operation（P〈0.05）; Among 28 cases, there were 26 cases who got graft bed, 1 cases who got lesions around the transparent corneal endothelium, 1 cases having mild edema; After follow-up for one year, there was only one patient having rejection reaction, but there was no recurrence of viral keratitis. Conclusion It can achieve good effect for the penetrating keratoplasty on the treatment of severe necrotizing stromal keratitis, and it can significantly improve the best corrected visual acuity, and decrease rejection reaction and recurrence rate. It has high safety, and it is worthy of promotion.