穿透人工角膜植入术的初步临床观察

Primary clinical study on penetrating keratoprosthesis implantation

目的 应用穿透人工角膜植入术使角膜移植失败或难以进行角膜移植的角膜白斑患者脱盲。方法 应用Yakimenko型人工角膜对4例化学烧伤后角膜白斑和1例爆炸伤后的角膜白斑进行了穿透人工角膜植入术。术前3例光定位准确,2例光定位不准确。结果 术后1眼视力无变化。4眼视力有不同程度的提高(0.09～0.6),其中最好的1例术后裸眼视力为0.6,矫正视力为0.8,观察时间9个月～3年。结论 应用耳软骨加固人工角膜植床是一个行之有效的方法,对不能行角膜移植和角膜移植失败但尚存光感的角膜白斑患者,穿透人工角膜植入术是目前首选的复明手术。

Objective To observe the effectiveness of penetrating keratoprosthesis implantation in patients who failed to or were not suitable for keratoplasty. Methods Five patients with leucoma induced by chemical burn and blast received Yakimenko keratoprothesis implantation. Results Postoperative vision elevated (0.09-0.6) in 4 of 5 patients during 9 months to 3 years after surgery. The best naked-eye vision among these patients was 0. 6,and corrected vision was 0. 8. The vision in 1 case remained unchanged. Conclusion The results suggest that keratoprosthesis reinforced recipient bed with ear cartilage is an effective method. Keratoprosthesis implantation is probably the best therapeutic choice for those patients who failed to keratoplasty or are not suitable for keratoplasty with light sense.