复杂性角膜穿孔伤角膜移植手术对植片内皮细胞的观察研究

目的探讨复杂性角膜外伤后穿透性角膜移植手术角膜植片内皮细胞的变化。方法用角膜内皮显微镜对穿透性角膜移植联合手术12例（12眼）的术后移植片行内皮细胞摄像分析，并用超声角膜测厚仪测量术前供体角膜及术后移植片厚度。结果穿透角膜移植术后远期角膜内皮丧失率为34．98％，平均细胞面积明显增大，变异系数也明显增大，六角形细胞比例下降，但植片的厚度在正常范围内。其中11例移植片保持透明，表明多数未发生内皮细胞功能失代偿。结论穿透性角膜移植在严格掌握适应证的情况下是一种安全的方法，虽然移植片内皮细胞各种指标变化较大，但其厚度正常，透明成功率较高，所以穿透角膜移植联合手术仍不失为治疗复杂性角膜穿孔伤的良好办法。

Affection in donor corneal endothelium following combined penetrating keratoplasty

Objective To study the change of donor corneal endothelium following penetrating keratoplasty for complex perforating corneal trauma. Methods Specular microscopy of donor eorileal endothelium was perfomed on 12 patients（ 12 eyes） who underwent combined keratoplasty. The thickness of donor cornea and grafts were measured before the opertation. Results The loss rate of corneal endothelium was 34.98% in postoperative 1.5-2 years. The average area oftbe donor corneal endothelium and the CV increase. The percentage of hexagonal cell of donor corneal endothelium decreased after operation 1.5 - 2 years. The thickness of grafts was normal. Conclusion After combined penetrating keratoplasty, the density of donor corneal endothelium would decrease the average cell area and CV increase and the hexagonality decrease. Combined penetrating keratoplasty was a safe surgery.