不剥除植片后弹力层的深板层角膜移植术治疗圆锥角膜的初步临床观察

Preliminary clinical study of non-Descemet stripping deep anterior lamellar keratoplasty for keratoconus

目的探讨不剥除植片后弹力层的深板层角膜移植术治疗圆锥角膜的安全性和临床效果。方法收集2018年1月至2020年1月在西安市第一医院住院的圆锥角膜患者6例(6眼),均采用不剥除植片后弹力层的深板层角膜移植术,术后随访12~24个月,观察患者术后视力,植片透明度和贴附情况,以及中央角膜厚度变化。结果随访期间所有患者角膜植片透明,植片与植床贴合紧密;6例患者术后裸眼视力较术前均显著提高;术后早期6例角膜中央厚度均高于正常,其中2例>600μm,4例>570μm,术后角膜厚度逐渐下降,3个月后无明显变化。结论不剥除植片后弹力层的深板层角膜移植术治疗圆锥角膜具有良好的安全性和临床效果。

Objective To investigate the safety and clinical effects of non-Descemet stripping deep anterior lamellar keratoplasty for keratoconus.Methods A total of 6 patients(6 eyes)of keratoconus who were hospitalized in Xi´an No.1 Hospital from January 2018 to January 2020 were collected;all of them underwent non-Descemet stripping deep anterior lamellar keratoplasty.Postoperative follow-up was performed for 12 to 24 months,and postoperative visual acuity,graft transparency and adhesion,and changes in central corneal thickness were observed.Results During the follow-up period,the corneal grafts of all patients were transparent,and the grafts adhered closely to the implant bed.The visual acuity of 6 patients was significantly improved than that before the operation.The central corneal thickness of 6 patients was higher than normal in the early postoperative period.Among them,2 cases were higher than 600μm and 4 cases were higher than 570μm.The corneal thickness gradually decreased after the operation,and there was no significant change after 3 months.Conclusion Non-Descemet stripping deep anterior lamellar keratoplasty for keratoconus is safety and effective.