深板层角膜移植术治疗急性期圆锥角膜的探讨

目的 观察深板层角膜移植术治疗急性期圆锥角膜的手术时机及临床效果.方法 总结自2008年9月至2009年9月于邢台眼科医院住院的急性期圆锥角膜患者8例,均于发病后2～3周采用深板层角膜移植术治疗,术后随访观察6～12个月,观察角膜植片的透明度及视力情况.结果 8例患者中,术前裸眼视力4例为手动,4例为眼前指数,矫正均不提高;术后裸眼视力为0.2～0.5的6例,≥0.6的2例,术中发现后弹力层裂孔呈裂隙状;术后6例大部分裂孔已愈合,角膜植片透明;2例裂孔较大者(尚有约1mm未愈合)术后第3天发现少许层间积液,植片基质层轻度水肿,经前房补气及包扎后层间积液吸收,角膜植片恢复透明;全组病例后弹力层破裂处无明显混浊.结论 深板层角膜移植术治疗急性期圆锥角膜可以取得较好的临床效果.

Deep lamellar keratoplasty for treatment of acute keratoconus

Objective To observe the timing of surgery and clinical results of the deep lamellar keratoplasty for treatment of acute keratoconus. Methods Eight cases of in patients with keratoconus in the acute stage of hospitalization were operated using deep lamellar keratoplasty since September 2008 to September 2009 at the Xingtai Eye Hospital, postoperative follow-up observation was from 6 months - 1 year to observe the corneal transparency of the graft and visual conditions. Results The preoperative uncorrected visual acuity in 4 cases was hand move, 4 cases finger count, could not corrected; postoperative uncorrected visual acuity of 0.2-0.5 in 6 eyes, ≥0.6 in 2 eyes, corrected visual acuity ≥0.4. Intraoperative Descemet's layer hole was found in slit-like, most of hole in 6 cases healed, and 2 cases of hiatus was greater (there was about 1mm did not heal). There was effusion found within layers of graft stroma 3 days after surgery. Light degree of edema was treated with anterior chamber air injection and wrapping to let the layer of fluid absorption, corneal graft restored transparency. All cases those underlying Descemet's rupture had no significant turbidity. Conclusions Deep lamellar keratoplasty for treatment of acute keratoconus can obtain better clinical effects.