全角膜移植术后免疫排斥反应的探讨

目的：评价对严重全角膜病变行带环形板层巩膜瓣全角膜移植术（CST）后免疫排斥反应的临床疗效。方法：对用药无法控制的严重全角膜病变患者10例进行回顾性研究，其中化脓性角膜溃疡9例，大泡性角膜病变伴全角膜白斑1例，全部病人均行CST。结果：随访1-23个月，平均10.2个月，10例视力均有不同程度提高；8例植片透明，2例植片半透明；5例术后3-4个月出现角膜新生血管（其中2例植片半透明）；2例术后半年出现免疫排斥反应。结论：CST是治疗严重角膜病变的有效方法，不但挽救眼球且能恢复一定的视力。

An evaluation on immunological rejection after total corneal transplantation

Objective:To evaluate the clinical effect of immunologic rejection after total corneal circular lamellar sclera transplantation(CST)for severe whole keratopathy.Methods:Ten patients with severe whole keratopathy by inefficacious drug treatment were retrospective study.Among the ten cases,nine cases had total purulent corneal ulcer and one case had bullous keratopathy with total corneal leucoma.CST was performed on all the patients.Visual acuity,corneal grafts and complications were observed postoperatively.Results:The follow up was 1 to 23 months (mean 10.2 months).Visual acuity was improved in all cases.Eight corneal grafts were transparent and two grafts were semitransparent.The corneal neovascularization emerged on five cases during 3 to 4 months after surgery and two grafts were semitransparent.The immunological rejection emerged on two cases during 6 months.Conclusion:CST is an effective method for severe whole keratopathy.Not only the eyeball is saved but also the visual acuity is improved.