飞秒激光辅助的穿透性角膜移植联合手法碎核白内障摘除人工晶状体植入术

目的：探讨同时行飞秒激光辅助的穿透性角膜移植术（ PKP）及小切口手法碎核白内障摘除联合人工晶状体植入术治疗同时患有白内障及角膜病患者的适应证、手术技巧及术后疗效。方法应用飞秒激光辅助的PKP联合小切口手法碎核白内障摘除人工晶状体植入术治疗同时患有白内障及角膜病的患者6例（6只眼），观察其术后裸眼视力、最佳矫正视力、眼压、植片、人工晶状体情况及前房反应。随访9个月。结果治疗后6例术后裸眼视力均比术前有不同程度的提高，术后9个月裸眼视力≥0．3者4例，0．2者2例；5例最佳矫正视力≥0．5，1例最佳矫正视力为0．4。术后7～14 d，5例角膜植片全透明，1例角膜植片轻度水肿。至术后9个月，6例角膜植片全透明；6例术后眼压均正常，人工晶状体位置正，位于囊袋内。结论飞秒激光辅助的PKP联合小切口手法碎核白内障摘除人工晶状体植入术对眼球损伤更小、手术效果更确切、治疗病程更短，可以一次性解决眼前段的屈光间质混浊。与传统分期手术相比减少了术后并发症，使患者快速恢复术后视力，安全性较高。

Femtosecond laser-assisted penetrating keratoplasty combines small incision manual nucleofragmentation and foldable intraocular lens implantation

Objective To study the indications, surgical technique and postoperative outcomes of femtosecond?laser-assisted penetrating keratoplasty combined with small incision manual nucleofragmentation and foldable intraocular lens implantation.Methods Six cases (6 eyes) with cataract and corneal diseases were treated with femtosecond laser-asssisted penetrating keratoplasty, small incision manual nucleofragmentation, and foldable intraocular lens implantation. Postoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), intraocular pressure, corneal grafts, intraocular lens and anterior chamber reaction were observed.Follow up period was 9 months.Results Both UC-VA and BCVA improved in all patients.At 9 months after surgery, UCVA was better than 0.3 in 4 patients and was be-tween 0.2~0.3 in 2 patients.BCVA was higher than 0.5 in 5 patients and between 0.4~0.5 in 1 patient.Corneal graft was completely transparent at 7~14 days in 5 patients.In 1 patient, corneal edema was observed.All patients achieved complete transparence at 9 months.Intraocular pressure was normal, and lens position was correct in all patients.Conclu-sion For patients with coexisting cataract and corneal diseases, femtosecond laser-assisted penetrating keratoplasty com-bined with small incision manual nucleofragmentation and lens implantation will result in reduced trauma, shorter duration of recovery, better visual outcomes, and less complications.It is an effective and safe treatment for such patients.