摘要
目的 为了使全角膜穿透性移植术 (TPK)后移植片混浊的病人复明 ,再次行部分穿透性角膜移植术 (PPK) ,观察疗效。方法 对 1 8例TPK术后出现移植片混浊的连续病例 ,再行PPK (甚或多次PPK)治疗 ,观察和分析术后变化。结果 PPK后移植片透明率 55. 56 % ( 1 0 /1 8) ,视力 0 . 1及以上者 1 2例 ( 6 6 . 6 7% )。第一次PPK后 6例眼内压升高 ( 33 .33% ) ,UBM检查PAS及房角关闭 >1 /2周者 8例 ( 6 1 . 54% ) ,均较术前明显降低 (P <0 . 0 1 )。与移植片混浊关系密切的因素有 :原发病 ,角膜新生血管 ,PAS及房角关闭 >1 /2周 ,术前或术后行睫状体光凝术 ,术中联合小梁切除术等。结论 TPK后移植片混浊的病人可再次行PPK复明 ,但术后视力改善、移植片生存质量、术后青光眼发生、排斥反应等问题均需密切随访。术前纠正预先存在的危险因素 ,术中避免过多的手术干预 (尤其联合小梁切除术 ) ,术前、术后避免睫状体光凝术 ,可提高TPK后再次PPK成功率。
Objective To evaluated the clinical results and complications of the partial penetrating keratoplasty(PPK) for severe total graft failure after total penetrating keratoplasty(TPK)Methods Eighteen eyes of 18 consecutive patients who had underwent TPK for 10 2±2 8 months(range,7～19 months) were performed PPK for sevese total graft failure.Results After PPK,ten grafts were clear(55 56%),best correct visual acuity were 0 1 or better in 12 eyes(66 67%).Elevated intraocular pressure after PPK occurred in 6 eyes(33 33%),with UBM,PAS and goniosynechial closure over 1/2 circle were in 8 cases (61 54%),both of the two points were significantly lower than that before operation( P <0 01).Related factors to graft failure were primary keratotitis、vascularized cornea,broad PAS and goniosynechial closure(over 1/2 circle),ciliophotocoagulation pre-and post-PPK,additional procedures such as trabeculectomy.Conclusions PPK is effective to restore graft failure post-TPK.
出处
《中国实用眼科杂志》
CSCD
北大核心
2005年第3期224-229,共6页
Chinese Journal of Practical Ophthalmology
关键词
术后
治疗
术前
移植术
植片
TPK
穿透性
结论
纠正
目的
Total penetrating keratoplasty(TPK)
Partial penetrating keratoplasty(PPK)
Graft rejection
Glaucoma
