飞秒激光辅助的大气泡法深板层角膜移植术治疗圆锥角膜后视觉质量

发布时间：2018-09-14 15:58

【摘要】：目的观察飞秒激光辅助的大气泡法深板层角膜移植术(deep anterior lamellar keratoplasty,DALK)治疗圆锥角膜的视觉质量。方法使用自身对照观察法,纳入30例(50眼)圆锥角膜患者,均行飞秒激光下大气泡法DALK治疗,随访1 a观察疗效。结果30例(50眼)患者均顺利完成手术,术后早期术眼角膜植片均透明,角膜生理厚度恢复,植片与植床后弹力层贴合较好;术后7 d、1个月、6个月、1 a患眼裸眼视力、最佳矫正视力均高于术前(均为P0.05),术后不同时间点间差异均无统计学意义(均为P0.05)。术后不同时间点角膜曲率、角膜散光均较术前显著降低,角膜最薄点厚度较术前显著增加(均为P0.05),术后7 d、1个月、6个月、1 a间各指标差异均无统计学意义(均为P0.05)。术前内皮细胞密度为(2989.34±294.52)个·mm~(-2),术后1 a为(2821.19±325.51)个·mm~(-2),角膜内皮细胞丢失率为(5.62±0.56)%,术后7 d、1个月、6个月、1 a间差异不显著(均为P0.05)。术中未见并发症发生;术后1眼伤口哆开,1眼缝线松弛,1眼发生基质层免疫排斥反应,未见其他并发症发生。结论圆锥角膜行飞秒激光辅助的大气泡法DALK治疗,疗效确切,安全性高,是中晚期患者较佳的术式选择。
[Abstract]:Objective to observe the visual quality of femtosecond laser assisted deep lamellar keratoplasty (deep anterior lamellar keratoplasty,DALK) in the treatment of keratoconus. Methods 30 cases (50 eyes) of keratoconus were treated with DALK under femtosecond laser and followed up for 1 year. Results all the 30 cases (50 eyes) had successfully completed the operation, the corneal grafts were transparent, the corneal thickness recovered, and the elastic layer of the grafts fitted well to the bed, and the naked eyesight was found at 7 days, 1 month, 6 months and 1 year after the operation. The best corrected visual acuity was higher than that before operation (P0.05), but there was no significant difference between different time points after operation (P0.05). The corneal curvature and astigmatism were significantly decreased at different time points after operation, and the thickness of the thinnest point was significantly increased (P0.05). There was no significant difference in the indexes between 7 days, 1 month and 6 months after operation (P0.05). The density of endothelial cells was (2989.34 卤294.52) mm~ (-2) before operation, (2821.19 卤325.51) mm~ (-2) in 1 year after operation, and the loss rate of corneal endothelial cells was (5.62 卤0.56). There was no significant difference between 7 days, 1 month, 6 months and 1 year after operation (P0.05). No complications occurred during the operation and no other complications occurred in 1 eye. Conclusion Femtosecond laser assisted large bubble DALK is an effective and safe procedure for keratoconus.
【作者单位】：广西壮族自治区柳州市工人医院眼视光室;中山大学中山眼科中心;
【分类号】：R779.6

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