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目的临床总结应用深板层角膜移植术治疗圆锥角膜,深及角膜后板层的角膜斑翳,角膜溃疡,边缘性角膜变性以及格子样角膜营养不良的治疗效果,探讨深板层角膜移植术的临床应用适应症。方法总结2001年1月至2005年5月深圳市眼科医院住院行深板层角膜移植的患者共14例(18只眼),其中圆锥角膜2例,(病毒性)角膜斑翳2例,(细菌性)角膜斑翳2例,真菌性角膜溃疡2例,细菌性角膜溃疡3例,边缘性角膜变性3例(5只眼),格子样角膜营养不良2例(4只眼)。记录术后半年复诊视力及角膜曲率,并统计角膜移植并发症的发生。综合评估该手术的临床适应症。结果有2例发生排斥反应,其中1例为病毒性角膜斑翳,1例为真菌性角膜溃疡。有3例原发病复发,2例真菌性角膜溃疡,1例病毒性角膜溃疡。术后视力半年时查0.5以上的有13例,0.1以上的有2例,0.1以下的有3例。结论深板层角膜移植对治疗未及角膜后弹力层的病变有效,但在治疗感染性角膜溃疡及病毒性角膜斑翳的治疗效果差,易发生原发病的复发及角膜移植排斥反应。
Objective To summarize the clinical application of deep lamellar keratoplasty in the treatment of keratoconus, deep and corneal plaque, corneal ulcer, marginal keratosis and lattice-like corneal dystrophy. To investigate the effect of deep lamellar keratoplasty Clinical indications. Methods A total of 14 patients (18 eyes) with deep lamellar keratoplasty admitted to Shenzhen Ophthalmic Hospital from January 2001 to May 2005 were enrolled. Among them, 2 were keratoconus, 2 were (viral) corneal macula, Bacterial corneal macula, 2 cases of fungal corneal ulcer, 3 cases of bacterial corneal ulcer, 3 cases of borderline corneal degeneration (5 eyes) and 2 cases of lattice corneal dystrophy (4 eyes). Six months postoperative follow-up visual acuity and corneal curvature, and the incidence of corneal transplantation complications were recorded. Comprehensive assessment of the clinical indications of the operation. Results There were 2 cases of rejection, including 1 case of viral corneal macula and 1 case of fungal corneal ulcer. There are 3 cases of primary disease recurrence, 2 cases of fungal corneal ulcer, 1 case of viral corneal ulcer. After six months of visual acuity 0.5 or more in 13 cases, 0.1 more than 2 cases, 0.1 less than 3 cases. Conclusions Deep lamellar keratoplasty is effective in the treatment of lesions without corneal posterior elastic layer. However, it is ineffective in the treatment of infectious corneal ulcers and viral corneal macula and is prone to recurrence of primary disease and corneal graft rejection.