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1.
本文报道24例29眼圆锥角膜行穿透性角膜移植术治疗并随访0.5-6年,植片透明率达到100%,免疫排斥率为6.3%,术后80%矫正视力≥0.4,其中2眼术后裸眼视力分别为0.8和0.9,矫正视力达1.0。  相似文献   

2.
接触镜对101例圆锥角膜的矫正与治疗   总被引:20,自引:3,他引:17  
目的:探讨透气性硬性接触镜(RGPCL)对圆锥角膜眼的视力矫正与治疗效果。方法:观察101 例圆锥角膜,选择配戴RGPCL的病例,对其中角膜变形严重无法单独使用RGPCL的7 只眼采用了Piggyback lens(软性接触镜与硬性接触镜的组合使用)。随访时间1~24 个月。结果:以轻、中度圆锥角膜为主,处方RGPCL的基础曲率半径绝大多数大于7.30mm ,度数小于- 6.00D。RGPCL矫正视力达1.0、1.2 的占48 % ,0.6 以上的达82% ,明显优于框架眼镜。戴镜时间每日平均13.5 小时,无明显角结膜并发症出现。RGPCL戴用后角膜散光度平均减少1.70~2.21D,近视度平均降低0.75 ~2 .10D,角膜形状明显扁平化。Piggybacklens 明显改善了配适状态,提高了矫正视力和舒适度。结论:RGPCL对圆锥角膜的高度屈光不正矫正效果良好。在严密观察下,可对重症病例选择使用Piggybacklens。  相似文献   

3.
后圆锥角膜1例中山眼科中心眼科医院凌运兰,陈家祺角膜后圆锥是角膜后表面向前凸,1930年由Butler首次报导[1].国内湖南杜岱雪82年曾报告1例Kayer-Fleicher角膜环合并局限性后圆锥角膜[2]。于92年2月我们在门诊遇到1例,报告如下...  相似文献   

4.
患者男性,20岁,右眼视力0.12,-5.0 DS=1.2,左眼视力0.1,-3.75 DS  -1.0 DC×5°=1.2。角膜中央厚度:右574 μm,左眼585 μm,按常规行LASIK手术,角膜瓣厚度160 μm,直径为8.5 mm。术中不慎损伤右眼角膜瓣下方5∶00~7∶00位角膜瓣缘的上皮。术后左眼无异常,右眼疼痛流泪。第2天复查,左眼视力1.0,右眼视力0.12,试镜无提高。损伤的角膜上皮未完全愈合,角膜瓣略向鼻侧移位,当日在表麻下行角膜瓣复位术。第3天右眼角膜上皮愈合,对位良好,…  相似文献   

5.
准分子激光散光性角膜切削术治疗复合近视散光   总被引:4,自引:0,他引:4  
为评价准分子激光散光性角膜切削术(photoastigmatic-refractivekeratectomy,PARK)治疗复合性近视散光的效果,采用ker-atomⅠ型准分子激光机,利用准分子激光对角膜浅表层的椭圆形切削,共对57例82只复合近视散光眼行治疗,随访1年以上。术前近视球镜平均为-6.23±2.50D,散光为-1.47±0.82D,角膜散光为1.21±0.48D,最佳矫正视力为0.97±0.15。结果:术后视力和屈光状态在3~6个月趋于稳定,术后1年随访,近视平均为-0.52±1.00D,散光为-0.43±0.43D,相比术前散光平均降低70.7%;在术前散光≤0.75D、1.00~1.75D及≥2.00D三组中,其术后散光分别比术前降低60.3%、70.0%和74.9%,术后角膜散光平均为0.72±0.27D,比术前降低40.5%;术后裸眼视力:90.2%达到0.5或以上,72%达到0.8或以上。无严重手术并发症。结论:PARK是矫治散光的有效安全方法,主要用于矫正由规则对称角膜散光引起的复合近视散光  相似文献   

6.
评价准分子激光角膜切削术治疗角膜表面镜片术后散光的效果。采用Coherent产SCHWINDKERATOM准分子激光治疗系统对8例12只眼角膜表面镜片术后散光进行治疗,均为圆锥角膜术后病例,术前柱镜屈光度为-1.75—-10.00D,平均-5.49D±3.21D。术后随访6—15月,平均11.8月,显示裸眼视力均明显提高,矫正视力与术前相比提高者7只眼(58.33%)。柱镜平均屈光度由-5.49D下降至-2.77D,均无明显术后痛疼,术后角膜雾状混浊均不显著。说明准分子激光角膜切削术可有效地治疗角膜表面镜片术后的角膜散光,能显著地提高角膜表面镜片术治疗圆锥角膜的最终效果。  相似文献   

7.
经角膜切口行滤过术后的白内障摘出术   总被引:1,自引:0,他引:1  
何永奇  施玉英 《眼科》1996,5(3):174-175
56例具有功能性滤过泡的青光眼患者,在上方清亮角膜切口分别行白内障冷摘出术7例和白内障囊外摘出联合人工晶体植入术49例。术后1周内2例有暂时性眼压升高。术后6个月,56例患者眼压在1.78 ̄2.74kPa56例,56例中42例矫正视力0.5以上,9例在0.1 ̄0.5之间,5例视力不提高;散光值在0 ̄+2.50D之间。  相似文献   

8.
放射状角膜切开术的远期效果观察   总被引:2,自引:0,他引:2  
采用国际通用标准的放射状角膜切开术(radialkeratotomy,RK)器械和设备对近视平均-5.48D的155例(285只眼)行RK。对角膜散光超过1.00D者,联合行1~2对旗状横切口矫正散光。并对术后4~5年患者随访观察。结果表明,角膜屈光力平均降低3.98D,角膜散光由术前平均0.68D降至0.36D,等效球镜平均降低-4.74D。正视率、过矫率和低矫率分别为70.7%、15.5%及13.8%。最佳矫正视力下降2行以上者占3.4%。裸眼视力≥1.0者占63.8%,≥0.6者占89.7%。并发症中角膜微切穿及视力波动发生率分别为4.6%和34.1%。眩目发生率为8.8%,6个月后降至1.8%。术后1~2年,光学区内皮细胞丧失率平均为6.2%。  相似文献   

9.
表面角膜镜片术治疗有中央视区瘢痕的圆锥角膜   总被引:1,自引:0,他引:1  
王荣光  董东生  吕岚  邹留河 《眼科》1998,7(3):137-139
应用自制的表面角膜镜片对5例已有中央视区瘢痕的中晚期圆锥角膜者施行表面角膜镜片术,术中对4例行前房穿刺,降低眼压,以便充分地压平角膜圆锥,减低近视。结果:术后表面镜片上皮在3 ̄6天内完全再生,经过平均11个月的随访,术后裸眼视力较术前提高1 ̄5行,平均3行。矫正视力较术前提高4 ̄7行,平均5行。近视较术前减少5 ̄15.5D,平均11.0D。讨论:根据本组5例的手术治疗结果,证实对于中央视区有较薄瘢  相似文献   

10.
1临床资料1.1一般资料3例中,男2例,女1例,双眼2例,单眼1例。有近视史,视力严重减退就诊。眼科检查:5眼视力低于正常,4.0以下2眼,4.5以下3眼,2眼矫正不能提高,3眼提高4.8~5.1,角膜尖顶状变薄透明2眼,角膜中央混浊3眼,见Munson征阳性、Descemet膜破裂、Fleischer环,角膜未混浊。眼检影几眼底反光漩涡式冲突状影,其中1例患“甲状腺机能亢进”,余全身无异常。1.2治疗方法3例均给予氯强眼药水滴患眼,10min1次。6次后结膜囊涂四环素可的松眼膏,用眼垫轻加压包…  相似文献   

11.
12.
J M Frantz  M B McDonald  H E Kaufman 《Ophthalmology》1989,96(8):1151-7; discussion 1157-9
In the Nationwide Study of Epikeratophakia, 22 eyes underwent penetrating keratoplasty (PKP) after epikeratophakia for keratoconus. Reasons for PKP included visual acuity unsatisfactory to the patients (6 eyes), recipient corneal scarring (4 eyes), recipient Descemet's folds (3 eyes), scarring in the tissue lens (2 eyes), vascularization of the tissue lens (2 eyes), astigmatism (2 eyes), failure of the tissue lens to reepithelialize (1 eye), corneal ulcer (1 eye), and scarring of the donor and recipient cornea (1 eye). After PKP, all patients had clear grafts and 20/40 or better visual acuity. Average follow-up was 17 months. Three of the 22 patients (13.6%) had graft reaction episodes, all of which were treated successfully, resulting in clear grafts. The authors conclude that previous epikeratophakia does not adversely affect the outcome of subsequent PKP for keratoconus.  相似文献   

13.
Corneal sensitivity after epikeratophakia   总被引:1,自引:0,他引:1  
Corneal sensitivity was tested in 60 eyes of 30 patients who underwent unilateral epikeratophakia for the correction of aphakia (20 patients) or keratoconus (10 patients). Postoperative recovery time ranged from 2 months to 21 months (mean: 10 months). Our results indicate a relative hypesthesia of the epikeratophakia lenticule when compared with the peripheral host cornea and contralateral control cornea. However, corneal sensitivity tested in 11 patients with more than 1 year follow-up was increased compared with the sensitivity of 19 patients whose postoperative recovery was less than 1 year. Histopathologic findings in two lenticules from a nonhuman primate demonstrated sparse epithelial axon terminals. Host corneal nerves appear to innervate the lenticules by intraepithelial extension and by penetration of the superficial keratectomy scar.  相似文献   

14.
PURPOSE: To analyze the long-term effect of epikeratophakia (EKP) on corneal topography and visual acuity of eyes with keratoconus. METHODS: Retrospective study of 36 eyes 7.2 years after EKP. Four eyes underwent penetrating keratoplasty (PKP) and were excluded from further evaluation. Best-corrected visual acuity (BCVA) values were obtained from 32 eyes, corneal refraction and astigmatism from 23 eyes, surface asymmetry index (SAI) and surface regularity index (SRI) from 17 consecutive eyes that were operated upon after 1991, when the Tomey Topographic Modeling System became available. RESULTS: Only four eyes needed PKP. In addition to EKP six eyes had compression sutures and/or relaxing incisions, and one eye underwent photorefractive keratectomy. Mean refractive power of the cornea decreased from 51.8 to 45.8 and astigmatism from 7.2 to 3.8. SAI improved from 3.2 to 0.9 and SRI from 3.7 to 0.9. Mean BCVA was 0.3 preoperatively and 0.6 upon last follow-up. CONCLUSIONS: EKP was able to render PKP unnecessary in 32 of 36 eyes during the entire observation period. It was successful in permanently flattening the ectatic cornea and reducing astigmatism while restoring a symmetrical and smooth corneal surface. As a result, visual acuity improved considerably. In view of the young age of keratoconus patients needing surgery, and the fact that the lifetime of full-thickness corneal grafts is limited, EKP should be considered a valuable alternative to PKP in contact-lens-intolerant cases of keratoconus without central scarring.  相似文献   

15.
本文通过兔眼表面角膜镜片术的临床和组织学观察,证实表面角膜镜片由受体角膜上皮和角膜细胞所代替,不引起税区瘢痕。此手术具有安全、简便、有效等优点,在国内外有用于治疗无晶体眼、圆锥角膜和高度近视等报告。  相似文献   

16.
We report 1-year follow-up findings on 42 of the first epikeratophakia procedures performed for keratoconus at the Helsinki University Central Hospital. Altogether 40 patients (42 eyes) received epikeratophakia grafts to flatten their cones. The age of the patients ranged between 19 and 44 years. The mean follow-up for these patients was 10.7 ± 4.4 months, and in 12 patients follow-up extended to over 12 months. Overall, the success rate for the procedure was 93%, and with repeated surgery it was 97% for all patients; in all patients uncorrected visual acuity improved. Preoperatively 82% of the patients had uncorrected acuity worse than 20/400, while all patients followed for 1 year had uncorrected visual acuity better than 20/400. At 6 and 12 months postoperatively best corrected visual acuities were all returned to within one line of their preoperative best corrected acuity; in 83% acuities were 20/40 or better 12 months postoperatively. Four patients out of 12 followed for 1 year needed no postoperative overrefraction at all. The mean flattening by keratometry readings was 9.8 diopters (D) and the mean decrease in myopia in terms of spherical equivalent was 5.3 D. The degree of irregular astigmatism was measured in five cases using LSU topographical corneal shape analysis, and showed that the mean preoperative irregular astigmatism of 3.9 D was reduced to 1.3 D in the long-term analysis. One case report is presented to show in detail the topographical changes induced by epikeratophakia in keratoconus. The noninvasive nature of the epikeratophakia procedure makes it a safe and desirable option for the treatment of keratoconus.This research was supported in part by grants from the Juselius Foundation and by the Finnish Eye and Tissue Bank Foundation, Finland  相似文献   

17.
PURPOSE: To compare the results of penetrating and non-penetrating corneal grafting procedures in mentally retarded keratoconus patients. METHODS: In the years 1974-2000 41 mentally retarded patients with keratoconus (33 with Down syndrome) were operated with corneal grafting. Mean age at operation was 36.7+/-10.8 years. Three different surgical procedures were used (no randomization): penetrating keratoplasty (n=16), lamellar keratoplasty (n=5) and epikeratophakia (n=20). In a retrospective study, the non-penetrating procedures (lamellar keratoplasty and epikeratophakia) were compared to the penetrating keratoplasties with regard to graft survival and frequency of serious complications. Mean follow-up time of all grafting procedures was 80+/-58 months. RESULTS: All cases of serious complications (irreversible rejection, wound leakage or perforation) occurred in the penetrating keratoplasty group (p=0.0005). Older age at operation (p=0.011) adversely influenced the frequency of serious complications. Overall five-year survival was 74.9%. Graft survival was not related to surgical procedure, but rather to age at operation (poorer survival in older age, p=0.012) and degree of retardation (poorer survival in patients with more severe retardation, p=0.051). CONCLUSIONS: Because of the safety and low frequency of complications, epikeratophakia is recommended as the grafting procedure of choice in the majority of mentally retarded with keratoconus. In selected cases (good cooperation, age < or =40 years, and a good peripheral corneal thickness) penetrating keratoplasty may be performed, which, if uncomplicated, often will give better functional/optical results.  相似文献   

18.
Xie LX  Gao H 《中华眼科杂志》2007,43(3):228-232
目的探讨角膜表层镜片术(EP)联合Ⅱ期准分子激光角膜切削术(PRK)治疗圆锥角膜完成期的临床疗效。方法(1)病例入选标准:①EP入选标准:圆锥角膜完成期患者,角膜中央区无瘢痕,最佳矫正视力(BCVA)≤0.3,角膜曲率≤60.0D;②Ⅱ期行PRK入选标准:角膜拆线后3个月内散光变化〈0.5D,年龄〉18岁,无其他眼部疾病。(2)手术治疗:对进入手术入选标准的患者常规Ⅰ期行EP,Ⅱ期行PRK。(3)术后随访:观察术后植片情况,记录视力、散光变化及并发症发生情况。结果8例(10只眼)患者接受了Ⅰ期EP联合Ⅱ期PRK,术后平均随访时间为40.6(30~94)个月。(1)视力:EP术后12~18个月(角膜全拆线行PRK术前),10只眼BCVA均〉0.3,其中0.3~0.5者1只眼,≥0.5者9只眼;行PRK术后〉12个月,10只眼BCVA均≥0.5,其中5只眼BCVA达到1.0。(2)角膜散光:EP术前平均角膜散光为(7.3±1.8)D,EP术后12~18个月平均角膜散光为(3.8±1.6)D,PRK术后24个月以上,平均角膜散光为(1.6±0.9)D。(3)植片情况:EP术后所有植片透明,无免疫排斥反应发生。PRK术后1只眼发生0.5级的角膜上皮下雾状混浊,未见圆锥角膜复发。(4)术后并发症与处理:1例(1只眼)患者EP术后当天继发青光眼,前房消失,急诊行前房重建后缓解;1例(1只眼)患者EP术后植床出现较大皱褶,1例(1只眼)患者EP术后3个月内缝线松动,行植片重缝后缓解。结论Ⅰ期EP联合Ⅱ期PRK可能是治疗圆锥角膜完成期的有效方法,行PRK术后视力长期稳定。  相似文献   

19.
目的评价OrbscanⅡ存准分子激光角膜屈光手术中的应用价值。方法对拟行准分子激光手术的600例(1196眼),术前行OrbscanⅡ检查,以排除圆锥角膜、可疑圆锥角膜及中央角膜厚度过薄不适宜行LASIK手术者;术后检查200例(400眼),了解有无偏心切削、中央岛等情况。结果术前查出网锥角膜(5例)10眼,占0.84%;角膜偏薄56眼,占4.68%。术后查出偏心切削9眼,占2.25%,未发现中央岛。结论OrbscanⅡ是角膜屈光手术前重要的检查手段,对手术方案的设计及术后效果的评价提供了重要依据。[1]  相似文献   

20.
Xie L  Gao H  Shi W 《Cornea》2007,26(10):1200-1204
PURPOSE: To determine the long-term safety and effectiveness of photorefractive keratectomy (PRK) in the treatment of refractive errors after epikeratophakia (EP) for keratoconus. METHODS: Ten patients (14 eyes) who had refractive errors after EP for keratoconus received PRK surgery. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), refractive error, corneal astigmatism, pachymetry, corneal topography, and complications were monitored. RESULTS: Mean follow-up after PRK was 63.4 +/- 19.8 months. Mean spherical equivalent was -5.5 +/- 3.9 D before PRK, -0.9 +/- 0.5 D at 1 month after PRK, and -1.5 +/- 1.0 D at 3 years. Mean astigmatism was 4.2 +/- 2.1 D before PRK, 1.2 +/- 0.5 D at 1 month after PRK, and 1.5 +/- 0.6 D at 3 years. Thirteen (93%) eyes had an UCVA <20/40, and 12 (86%) had a BSCVA of 20/40 or better before PRK. At 1 year, the UCVA was 20/40 or better in 8 (57%) eyes, and the BSCVA was 20/40 or better in all eyes. Mean central corneal thickness was 749 +/- 35 microm before PRK and 621 +/- 56 mum at 3 years. During the follow-up period, haze (grade no more than 1.0) was observed in 2 eyes. No immune rejection episode or recurrent keratoconus was found. CONCLUSIONS: PRK appears to be reliable and safe for the correction of residual ametropia after EP for keratoconus, and the visual acuity can remain stable after PRK for a long time.  相似文献   

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