中国飞秒激光辅助角膜移植手术专家共识(2022年)

Chinese expert consensus on femtosecond laser-assisted keratoplasty(2022)

角膜移植手术是角膜盲复明的主要方法,分为治疗性角膜移植手术和光学性角膜移植手术。光学性角膜移植手术的关键在于制备规则的供体角膜材料和植床、良好的缝合技术以减少术源性角膜散光等。传统环钻辅助角膜移植手术主要使用环钻制备角膜植片和植床,精细度不足,是影响术后视力恢复的重要原因。相比传统环钻辅助角膜移植手术,飞秒激光辅助角膜移植手术(FLAK)制备角膜植片和植床更加精细,从而可获得更好的光学性角膜移植手术效果。FLAK涉及到屈光手术医师与角膜移植手术医师协作,具有不同于传统环钻辅助角膜移植手术的特殊手术程序。为推动我国临床规范开展FLAK,中华医学会眼科学分会角膜病学组汇集国内外研究结果,结合相关专家的临床经验,经过充分讨论,针对FLAK的适应证、手术设计和步骤、并发症处理及围手术期用药等提出共识性意见,以期为临床工作提供指导和参考。

Corneal transplantation,which can be divided into therapeutic keratoplasty and optical keratoplasty,is the main method to restore vision for patients with corneal blindness.The keys to optical keratoplasty are the regular excision and preparation of donor and recipient corneas,as well as well-developed suturing skills to reduce surgically induced astigmatism.Traditional keratoplasty mainly relies on trephination to prepare the corneal graft and the recipient bed,but this procedure lacks precision,which is an important factor affecting postoperative vision recovery.In this regard,femtosecond laser-assisted keratoplasty(FLAK)can get more precise results compared with the traditional trephine-assisted keratoplasty,thereby achieving better optical keratoplasty effects.FLAK requires the cooperation between corneal refractive surgeons and corneal transplantation surgeons,and the surgical procedure also differs from that of traditional trephine-assisted keratoplasty.To promote and standardize the implementation of FLAK in China and to provide guidance on its clinical practice,the Cornea Group of Ophthalmology Branch of Chinese Medical Association has formulated this consensus on the indications,surgical design and procedures,complications and perioperative medication management of FLAK after thoroughly discussing the domestic and foreign research results collected,combined with the clinical experience of experts in this field.