摘要
目的利用裂隙灯适配光学相干断层扫描成像术(SL-OCT)观察角膜移植术后植片与植床的对合及愈合情况。方法使用SL-OCT对16例16眼穿透角膜移植术(PKP)和10例10眼小切口深板层角膜内皮移植术(DLEK)后进行扫描检查,记录扫描图像并使用仪器自带软件对图像进行分析。结果PKP术后,植片与植床对合良好者9例,对合欠佳者7例,其中4例发生虹膜前粘连。DLEK术后,9眼植片与植床贴合良好,其中4例植片边缘略突出于植床外,1例植片边缘向内卷曲。对侧正常眼角膜厚度与PKP和DLEK术后的差异均有统计学意义(Z=16.379,P=0.000);对侧正常眼中央前房深度与PKP和DLEK组之间的差异无统计学意义(P>0.05)。结论SL-OCT对于判断术后植片与植床的愈合情况以及早期发现术后并发症有重要意义。
Objective The observation：of the healing process of graft after penetrating keratoplasty （PKP） or deep lamellar posterior endothelial keratoplasty（DLEK） was rather difficult by the equipments available up to now. The slit lamp adapted optical coherence tomography （SL-OCT） could provide in vivo, in situ, cross-sectional images of cornea with high resolution and noninvasiveness. The aim of current study was to apply SL-OCT to observe the healing process of graft after PKP and DLEK. Methods PKP and DLEK was performed on the unilateral eyes of 16 and 10 patients respectively. The healing process of corneal graft was observed with slit lamp adapted optical coherence tomography （ Heidelberg SL-OCT）. The fellow eyes were as control eyes. Results A fine adaptive relationship between graft and recipient bed was found in 9 eyes,and the grafts were thinner in 5 eyes and thicker in 2 eyes in PKP group,4 eyes of which occurred synechia. In DLEK group, the majority （9 eyes） had excellent engomphosis between graft and recipient bed,including a little bit thicker graft in 4 cases and graft edge curling in 1 eye. The corneal thickness of the fellow eyes was （552.29 ± 31.99）μm, and that in PKP and DLEK groups was （613.79 ± 120. 3 ） μm and （ 670 ±225.2 ）μm respectively, indicating a statistically significant difference （ Z = 16. 379, P = 0. 000 ）. The anterior chamber depth of the fellow eyes was （2.62 ＋ 0.37 ）ram, and that in PKP and DLEK groups was （2. 27±0.88 ）mm and （ 2. 96 ±0. 73 ） mm respectively without statistically significant difference among them （ Z = 3. 347, P = 0. 197 ）. In the bilateral keratoconus eyes,the corneal thickness was （574.5 ±21.8）μ m and （406.5 ± 64. 1 ） μm,and the anterior chamber depth was （3. 12 ±0.04）mm and （3.46 ±0. 23 ）mm in operation eyes and nonoperation eyes respectively, presenting a evident difference between them（t = 13.276,P =0.001;t =6.756,P =0.034 ）. Conclusion SL-OCT is a good tool during the follow-up in keratoplasty patients. It is crucial in observing the healing process and postoperative complications as early as possible.
出处
《眼科研究》
CSCD
北大核心
2008年第4期291-295,共5页
Chinese Ophthalmic Research
