全角膜移植术治疗严重全角膜病变的探讨

An evaluation of treatment for severe whole keratopathy by total corneal transplantation

目的 评价带环形板层巩膜瓣的全角膜移植术治疗严重全角膜病变的临床疗效。方法 我们对用药无法控制的严重全角膜病变 9例进行回顾性研究 ,其中化脓性角膜溃疡 8例 ,大泡性角膜病变伴全角膜白斑 1例。观察术后视力、植片及并发症。结果 随访 1～ 2 3月 ,9例视力均有提高 ,8例植片透明 ,1例植片半透明。 5例术后 3～ 4月出现角膜新生血管。结论 全角膜移植术是治疗严重角膜病变的有效方法 ,不但能挽救眼球而且能恢复一定的视力。

Objective To evaluate the clinical effect of total corneal with circular lamellar sclera transplantation (CST) for severe whole keratopathy. Methods 9 patients with severe whole keratopathy by inefficacious drug treatment were retrospective study,among the 9 cases,8 cases with total purulent corneal ulcer,1 case with bullous keratopathy and total corneal leucoma.CST was performed on all the patients.visual acuity,corneal grafts and complication were observed postoperatively. Results The follow up was 1 to 23 months,visual acuity was improved in all cases.8 corneal grafts were transparent and 1 case was semitransparent.The corneal neovascularization emerged on 5 cases during 3 to 4 months after operation. Conclusion CST is an effective method for severe whole keratopathy,not only the eyeball is saved but also the the visual acuity is improved.