干燥法长期保存角膜片板层治疗性角膜移植1267例临床研究

目的评价干燥脱水法长期保存角膜片在板层治疗性角膜移植术中的效果。方法保存角膜片选自我院眼库干燥保存符合临床标准、复水透明的完整角膜片,临床病例选自我院角膜病组1976年8月～1999年12月期间行板层治疗性角膜移植患者1267例,从手术前后观力比较、原发病灶控制、植片存活情况进行临床效果综合分析。结果保存角膜片复水透明合格率为94.9％,临床治愈率:感染性角膜溃疡/穿孔88.8％,血管翳性全角膜白班98.3％.化学及热烧伤(穿孔,睑球角粘连等)92.1％,圆锥角膜及急性圆锥角膜99.5%,角膜变性(边缘性及前基质层)99.0％,其他88.9%,平均总治愈率93.5％。结论①对各种严重的角膜感染、药物治疗无法控制的患者,治疗性角膜移植术是唯一有效的方法。②采用无水氯化钙-硅胶干燥脱水长期保存的供体角膜能为临床随时提供角膜材料,是一项简单易行、便于推广应用的成功率很高的保存方法。

Clinical Study on 1267 Cases of Lamellar Therapeutic Keratoplasty Using Dehydrated Corneal Grafts in Long-time Storage

Objective To evaluate 1267 cases of therapeutic keratoplasty using dehydrated corneal grafts in long-time storage.Methods The corneal grafts had been stored in Xi'an Eye Bank and they conformed to the clinical demands. A total of 1267 cases of therapeutic keratoplasty performed in our hospital between Aug. 1976 to Dec. 1999 were analysed in the way of preoperational and postoperational vision, control of original focuses, and survival of corneal grafts. Results The transparent rate of corneal grafts after preservation was 94.9%; the clinical cure rate was respectively 88.8% in infective corneal ulcer/perforation, 98.3% in pannus totalis and corneal opacity, 92.1% in chemical burns and heat burns (perforation, corneoblepharon), 99.5% in keratoconus and acute keratoconus, 99.0% in corneal degeneration(marginal, shallow of stroma) and 88.9% in other cases, the mean cure rate being 93.5%. Constorage is easy, simple and highly applicable.