穿透性角膜移植治疗人工晶状体植入术后大泡性角膜病变的临床观察

目的 评价穿透性角膜移植术治疗人工晶状体植入术后大泡性角膜病变临床疗效,探讨术中对原人工晶状体的处理。方法 对12例(12只眼)人工晶状体植入术后大泡性角膜病变施行穿透性角膜移植术或穿透性角膜移植术联合手术,观察术后角膜植片及视力变化。结果 随访6～16个月,平均11．2个月,术后临床症状明显缓解或消失,植片保持透明,视力较术前均有提高,其中矫正视力0．02以上11例(0．2以上4例);术后继发性青光眼1例,内皮型排斥反应1例。结论 穿透性角膜移植术是治疗人工晶状体植入术后大泡性角膜病变的一种理想手术方式,不仅能消除刺激症状且能增进视力。术中如何处理人工晶状体应视眼部具体情况。     

穿透性角膜移植术治疗内眼术后大泡性角膜病变

目的：评价穿透性角膜移植术治疗内眼术后大泡性角膜病变的临床疗效。方法：我们对因内眼术后发生大泡性角膜病变的11例病人进行回顾性研究，其中9例行穿透性角膜移植术，1例行穿透性角膜移植术联合白内障囊外摘除、后房型人工晶体植入术，1例行带环形板层巩膜瓣的全角膜移植术。观察术后视力及植片情况。结果：随访4～36个月，平均16．6个月，眼部刺激症状均缓解，术后视力提高10眼，视力无改变1眼；术后9例角膜植片透明，2例再次行穿透性角膜移植术联合小梁切除术。结论：穿透性角膜移植术是治疗大泡性角膜病变的有效方法，不但缓解症状且能不同程度提高视力。     

穿透性角膜移植治疗人工晶体植入术后大泡性角膜病变的临床观察

目的探讨穿透性角膜移植术治疗人工晶体植入术后大泡性角膜病变临床疗效。方法对21例（21眼）人工晶体植入术后大泡性角膜病变施行穿透性角膜移植术或穿透角膜移植联合手术，观察术后视力及植片情况。结果随访6～18个月，平均11．6个月，术后临床症状明显缓解或消失，视力较术前均有提高，其中矫正视力0．02以上17例（0．2以上7例）；术后继发性青光眼2例，内皮型排斥反应1例。结论穿透性角膜移植术是治疗人工晶体植入术后大泡性角膜病变的一种理想手术方式，不但缓解症状且能不同程度提高视力。     

穿透性角膜移植治疗外伤性角膜病变的临床观察

目的:探讨穿透性角膜移植术治疗外伤性角膜病变的临床疗效。方法:对17例外伤性角膜病变施行穿透性角膜移植术,2例行穿透性角膜移植术联合小梁切除术,观察术后角膜植片及视力变化。结果:随访6~18(平均11.2)mo,术后临床症状明显缓解或消失,植片透明率为84%。视力较术前提高,其中矫正视力0.05以上16例;术后继发性青光眼5例,内皮型排斥反应4例。结论:穿透性角膜移植术是治疗外伤性角膜病变的一种有效的手术方式,其主要并发症为继发性青光眼和角膜移植排斥反应。     

人工晶状体眼并发大泡性角膜病变及视网膜脱离时应用临时人工角膜进行眼前后节联合手术

目的探讨在人工晶状体眼合并大泡性角膜病变及视网膜脱离病例中应用临时人工角膜行玻璃体切割联合穿透性角膜移植的临床价值。方法对6例(6眼)人工晶状体眼合并大泡性角膜病变及视网膜脱离患者行临时人工角膜下玻璃体切割联合穿透性角膜移植术。结果6例患者术后视网膜均复位良好，5例角膜植片透明，1例患者视力达0．1．2例患者手术中取出人工晶状体。结论该手术是一种安全、有效的治疗手段，对保留人工晶状体眼合并大泡性角膜病变及视网膜脱离患者的眼球及部分视力起到了积极的作用。     

穿透性角膜移植治疗人工晶状体植入后大泡性角膜病18例

目的：评价穿透性角膜移植治疗人工晶状体植入后大泡性角膜病的方法和疗效。方法：人工晶状体植入后大泡性角膜病18例行穿透性角膜移植，其中9例单纯行穿透性角膜移植，8例行穿透性角膜移植联合术，1例取出前房植入普通后房型人工晶状体后行穿透性角膜移植，随访时间为4mo～2a。结果：术后随访13例植片透明，3例植片半透明，2例植片混浊。16例矫正视力在0．04～0．6，疼痛症状全部解除。结论：穿透性角膜移植联合术是目前治疗人工晶状体植入后大泡性角膜病较合理而有效的方法。     

穿透性角膜移植术治疗假晶体大泡性角膜病变的临床观察

目的：评价穿透性角膜移植术治疗假晶体大泡性角膜病变的临床疗效，探讨术中对原人工晶体的处理。方法：假晶体大泡性角膜病变１４例（１４只眼）。原人工晶体类型为后房型人工晶体１２例，弹性开放襻前房型人工晶体２例。手术方法为穿透性角膜移植术１２例，穿透性角膜移植联合人工晶体取出术２例。结果：术后临床症状均完全消失，所有植片均透明，矫正视力０．０２以上１２例（０．１以上４例）。随诊３￣２２个月，１３例植片透明     

人工晶体眼大泡性角膜病变的穿透性角膜移植

目的:研究人工晶体眼大泡性角膜病变行穿透性角膜移植的临床效果和保留或取出原人工晶体的适应证。方法:应用穿透性角膜移植治疗人工晶体植入术后大泡性角膜病变。结果:13例(13眼),术中保留原人工晶体11眼,取出原人工晶体2眼。术后随访平均16个月。随访期间角膜移植片全部透明,术后绝大部分病例视力获得提高,其中视力矫正达到0.2以上有5眼。结论:穿透性角膜移植是治疗人工晶体植入术后大泡性角膜病变有效方法。只要人工晶体位于囊袋内,位置正常,术中应保留原人工晶体,手术安全,术后视力恢复良好。眼科学报1998;14:227～228。     

角膜层间羊膜植入术治疗大泡性角膜病变

目的探讨角膜层间羊膜植入术治疗大泡性角膜病变的中远期临床效果。方法9例(9眼)大泡性角膜病变,根据病史、年龄和视力恢复的可能性,实施了角膜层间羊膜植入术。结果术后眼部刺激症状、角膜大泡均于2~5 d消失,角膜基质水肿于5~10 d消失。术后视力增进4例,无改变5例。随访2~27个月,平均(16.8±11.7)月无并发症发生,无复发者。结论对于症状明显、病情顽固、难以恢复有效视力或不具备角膜移植手术条件的大泡性角膜病变,角膜层间羊膜植入术不失为一种安全可靠的治疗方法。     

人工晶体植入后大泡性角膜病变的穿透性角膜移植

目的：评价穿透性角膜移植（Penetrating Keratoplasty,PK）治疗人工晶体植入后大光性角膜病变（Bullous Keratopathy,BK）的临床疗效。方法：采用PK治疗人工晶体植入后的BK12例（12眼）,观察术后角膜植片及视力变化。结果：随访8～14个月,平均10.6个月,角膜植片透明10例,半透明2例,术后视力提高8例,视力无改变的3例,视力下降1例。全部病人眼部刺激症状消失。术后继发青光眼3例。结论：PK是治疗人工晶体植入后BK的一种理想的手术方式,术中对人工晶体的处理和防止玻璃体脱出及出血是手术成功的关键。     

Cryopreserved amniotic membrane transplantation for the management of symptomatic bullous keratopathy

Background: To report the results of cryopreserved human amniotic membrane transplantation for the management of symptomatic bullous keratopathy. Methods: Prospective non‐comparative interventional case series study. Consecutive cases with symptomatic bullous keratopathy for more than 12 months not amenable to conservative treatment were managed with amniotic membrane transplantation. They were recruited over a 5‐year period (September 1999 to November 2004) in one referral centre. Only one eye of each patient (the worse affected eye in bilateral cases) was operated. A 360 degree conjunctival peritomy was followed by removal of the diseased corneal epithelium. Amniotic membrane was transplanted over the cornea as a patch and sutured to the free conjunctival edges. Primary outcome measures were ocular pain and epithelial defects; secondary measures were visual acuity and ocular surface inflammation. Results: Four out of 85 recruited cases did not complete the minimum observation of 12 months and were excluded from the study. The mean follow‐up period for the remaining 81 cases was 21 ± 4.2 months (range 14–34 months). Seventy‐one (87.6%) eyes became asymptomatic with healed epithelium, seven required repeated amniotic transplantation and three underwent penetrating keratoplasty. Visual acuity improved in 64 (79%) patients and remained unchanged in 14. No complications were recorded. Conclusions: Amniotic membrane transplantation is an efficient and safe treatment for symptomatic bullous kerato pathy, when penetrating keratoplasty is not available. It has been shown to alleviate pain, promote corneal epithelialization and reduce conjunctival inflammation whereas in some cases it may also improve visual acuity.     

穿透性角膜移植治疗大泡性角膜病变

本文对我院1985—1992年间用穿透角膜移植治疗大泡性角膜病变的结果作了回顾性研究。这些病例中大泡性角膜病变的原因:先后做过抗青光眼手术和白内障手术的14例;既往受过钝伤或穿破伤,以后又做过白内障手术的12例;前房型人工晶体植入术的3例;白内障摘出术后玻璃体疝接触角膜及晚期青光眼各4例;此外,还有Fuch‘s角膜内皮营养不良、ICE综合征及晚变期单疱角膜炎各1例。术前视力均在指数以下。随访时间3个月至5年,有28例(70％)移植片透明,7例(17.5％)半透明,5例(12.5％)移植片混浊。全部病例消除了疼痛症状,22例获得0.02—0.7的裸眼视力或矫正视力。作者在讨论中介绍了自己的临床经验和体会。     

A prospective study on the implantation of anterior chamber intraocular lenses during keratoplasty for pseudophakic and aphakic bullous keratopathy

Between April 1986 and April 1989, the authors conducted a prospective study of the use of open-loop anterior chamber intraocular lenses (AC IOLs) in patients undergoing penetrating keratoplasty for pseudophakic bullous keratopathy or monocular aphakic bullous keratopathy. All patients underwent the same operation--a penetrating keratoplasty combined with insertion of an open-loop AC IOL. Pseudophakic patients had an IOL exchange at the time of surgery. Thirty-six patients have been followed an average of 15 months. Thirty-two (89%) of the grafts are clear. Preoperatively, 100% of eyes had visual acuity less than 20/200. Postoperatively, 11 eyes (31%) have visual acuity better than 20/40 and 23 eyes (64%) have visual acuity better than 20/100. The most common causes for visual acuity less than 20/200 were cystoid macular edema, glaucoma, and immunologic graft failure. Using open-loop AC IOLs in patients with pseudophakic or aphakic bullous keratopathy can give good postoperative results and functional vision.