摘要
目的应用前节OCT（AS—OCT）对角膜内皮移植术（EK）术后植床和植片的位置关系进行观察。方法回顾性分析2007年9月-2009年4月北京大学眼科中心行角膜后弹力层剥除自动角膜刀取材内皮移植术（DSAEK）的患者42例（44眼），其中男30例，女12例；年龄15～83岁。术前术后分别行裂隙灯显微镜和AS-OCT检查，对比观察DSAEK术后植片与植床间的位置关系。结果28例患者在裂隙灯显微镜和AS—OCT检查均可清晰地显示植片贴附于角膜后表面、植片位置居中；术后不同时间植片、植床的厚度处于动态变化，随着时间的推移，植床水肿逐渐消退，植片和植床越来越稳定，贴附得更紧密，厚度变得更薄，角膜透明度增加；早期植片完全脱位者5例，占11．36％；植片部分脱位者2例，占4．55％；植片中央贴附良好，周围卷边者1例，占2．27％；植片偏位者8例，占18．18％。结论AS-OCT是评价EK术后植床和植片位置关系的有效工具。
Background The advantages of endothelium keratoplasty （EK） include without corneal surface incision and sutures, remaining normal corneal topography, minimizing astigmatism and providing a healthy donor endothelial cell count and function. Using anterior segment optical coherence tomography（AS-OCT） to examine the morphology of the corneal graft after EK is helpful for the evaluation of the outcome of EK. Objective This study applies AS-OCT to observe the relationship of recipient cornea and donor graft and offer a basis for the evaluation of operative outcome. Methods The clinical data from 44 eyes of 42 patient who received DSAEK in Peking University Eye Center from September 2007 through April 2009 was reviewed retrospectively. These patients included 30 male and 12 female with the age from 15 to 83 years. Structure of cornea and relationship between recipient cornea and graft disc after surgery were clinically examined and recorded by slit-lamp digital camera and AS-OCT. This study was approved by the Ethics Committee of Peking University. Written informed consent was obtained from all of the patients before the operation. Results The donor graft attached to posterior central surface of recipient in 28 eyes under the slit-lamp microscopy and AS-OCT. The thickness of donor graft was decreased, and graft sticked more closely to recipient cornea and was more transparent with the lapse of time. Complete dislocation of the donor graft in early stage was found in 5 eyes （11.36%） and partial dislocation in 2 eyes （4.55%）. Curliness of graft edge occurred in 1 eye （2.27%） and eccentricity of donor graft in 8 eyes（ 18. 18% ）. Conclusion AS-OCT can display the morphology and structure of cornea as well as the relationship between donor graft and recipient after DSAEK. It is helpful for evaluating the clinical effectiveness of DSAEK.
出处
《眼科研究》
CSCD
北大核心
2010年第1期50-54,共5页
Chinese Ophthalmic Research
关键词
前节OCT
角膜内皮移植
植床
受体
anterior segment optical coherence tomography
endothelium keratoplasty
donor graft
recipient
