老年人偏心性角膜小穿孔治疗评价

发布时间：2018-05-20 09:43

本文选题：穿透性角膜移植 + 甘油保存　；参考：《中国老年学杂志》2014年01期

【摘要】：目的评估小直径穿透性角膜移植术治疗老年人偏心性角膜小穿孔的安全、有效性,探讨该手术对治疗老年人偏心性角膜小穿孔的价值。方法对8例(8眼)65岁的老年偏心性角膜小穿孔患者行甘油保存角膜的小直径角膜移植手术,术后观察植片透明度、视力变化、术后并发症,分析角膜曲率计散光,记录角膜内皮细胞数量。结果 8例(8眼)均保持了眼球的完整性。角膜植片透明5例(62.5%),轻度瘢痕性混浊3例(37.5%)。所有患者未发生移植排斥反应等并发症。末次随访裸眼视力从术前的0.001~0.2提高到0.15~0.5(t=10.31,P=0.000),最佳矫正视力达0.25以上。术后角膜散光平均为(2.64±0.78)D。末次随访角膜内皮细胞数量平均为(2 485±260)cells/mm2。结论甘油保存角膜的小直径角膜移植术治疗老年人偏心性角膜小穿孔增视效果明显、能减少术后并发症。在角膜小穿孔急诊手术的情况下可用甘油保存角膜替代新鲜角膜。
[Abstract]:Objective to evaluate the safety and efficacy of small diameter penetrating keratoplasty in the treatment of eccentric corneal perforation in the elderly. Methods 8 cases of 65 years old patients with eccentric small perforation of cornea were treated with glycerol-preserved small diameter keratoplasty. The transparency of grafts, the changes of visual acuity, postoperative complications were observed and the astigmatism of keratometer was analyzed. The number of corneal endothelial cells was recorded. Results 8 cases (8 eyes) maintained the integrity of the eyeball. Corneal grafts were transparent in 5 cases (62.5%) and slight scar opacity in 3 cases (37.5%). No complications such as graft rejection occurred in all patients. At the last follow-up, the uncorrected visual acuity was improved from 0.001g / 0.2 to 0.150.31g / 0.000g, and the best corrected visual acuity was more than 0.25 (P < 0.05). The average postoperative astigmatism was 2.64 卤0.78 D. The average number of corneal endothelial cells at the last follow-up was 2 485 卤260 cells / mm2. Conclusion Glycerol preserved corneal small diameter keratoplasty is effective in the treatment of eccentric small corneal perforation in the elderly and can reduce postoperative complications. Glycerol may be used to preserve the cornea instead of fresh cornea during emergency surgery for minor corneal perforation.
【作者单位】：金华职业技术学院医学院眼科教研室;金华市人民医院眼科;
【基金】：金华市科学技术研究计划项目(2010-3-066)
【分类号】：R779.65

【参考文献】