角膜移植术后排斥反应的防治探讨

目的:为控制角膜移植术后发生排斥反应,探讨防治排斥反应的有效途径。方法:对73例73眼穿透性角膜移植术患者术后排斥反应发生率进行回顾性分析。结果:患者73眼中28眼发生免疫排斥反应(38%),其中高危角膜病变21眼,非高危角膜病变7眼,有角膜新生血管者占88%,排斥反应发生时间为术后2wk～3a,以内皮型排斥反应为主(43%)。经药物联合治疗,角膜排斥反应得到明显抑制,有效率达61%。结论:高危角膜病变免疫排斥反应几率明显增加,发生时间及持续时间较长,因此应根据不同角膜病变在术前、术中、术后采取相应措施减少排斥反应发生率。

Preventive treatment of the rejection after keratoplasty

AIM:To discuss the approach of prevention for the rejection after keratoplasty·METHODS:A retrospective analysis of the rate of rejection in 73 patients(73 eyes) was made after penetrating keratoplasty·RESULTS:The immunological rejection happened in 28 eyes(38%),consisting of 21 eyes with high risk keratopathy and 7eyes with non high risk keratopathy,corneal neovascularization took up 88%.The immunological rejection happened in 2 weeks to 3 years after keratoplasty.The corneal endothelium rejection occupied 43%.The immunological rejection were restrained after medication obviously,the effective percentage was 61%·CONCLUSION:The rate of rejection is markedly increased in eyes with high risk keratopathy,which persists long time.We should take measures before,during and after keratoplasty based on different keratopathy.