飞秒激光辅助的板层角膜移植早期临床效果

发布时间：2019-07-30 09:10

【摘要】：目的飞秒激光技术改变了传统角膜移植的方式。评价飞秒激光辅助的板层角膜移植(femtosecond laserassisted deep anterior lamellar keratoplasty,FALK)术治疗圆锥角膜及角膜基质病变的早期临床效果及安全性。方法 11例患者共12只眼(6只眼圆锥角膜,5只眼角膜炎术后角膜瘢痕,1只眼角膜基质层营养不良)采用FALK手术。供者及受者角膜均采用飞秒激光进行切削,供者板层角膜切割平均直径(7.79±0.20)mm,供者平均切割厚度为(395.00±52.67)μm。受者角膜切割平均直径为(7.59±0.15)mm。平均切割厚度为230~430μm,平均(322.00±59.41)μm。供者角膜切割直径比受者大0.2mm。术前平均角膜曲率为(53.21±11.51)D。术前角膜内皮细胞密度(endothelial cell density,ECD),平均(2 413.26±431.29)个/mm2。结果所有手术均顺利完成,术中无并发症,术后早期所有角膜植片透明。平均随访时间为(8.75±2.13)个月;术后最后一次随访,平均裸眼视力(uncorrected visual acuity,UCVA)为0.25±0.27,与术前(0.10±0.07)相比,差异有统计学意义(P0.01),平均最佳矫正视力(best corrected visual acuity,BCVA)为0.45±0.26,与术前(0.28±0.27)相比差异均有统计学意义(P0.01),术后角膜平均曲率为(44.82±2.91)D,术后ECD平均(2350.94±406.17)个/mm2,内皮细胞丢失率为2.6%,与术前相比,差异无统计学意义(P0.05)。结论 FALK对于角膜基质病变具有良好的临床效果及安全性。
[Abstract]:Objective Femtosecond laser technology has changed the traditional way of corneal transplantation. To evaluate the early clinical effect and safety of femtosecond laser-assisted lamellar keratoplasty (femtosecond laserassisted deep anterior lamellar keratoplasty,FALK) in the treatment of keratoconus and corneal stroma. Methods FALK was performed in 12 eyes of 11 patients (6 eyes keratoconus, 5 eyes with corneal scar and 1 eye with corneal stroma dystrophy). The donor and recipient cornea were cut by femtosecond laser. The average diameter of donor lamellar keratectomy was (7.79 卤0.20) mm, and the average cutting thickness of donor was (395.00 卤52.67) 渭 m. The mean diameter of corneal incision was (7.59 卤0.15) mm.. The average cutting thickness is 230 ~ 430 渭 m, and the average cutting thickness is (322.00 卤59.41) 渭 m. The diameter of donor corneal incision was 0.2 mm larger than that of recipient. The mean corneal curvature before operation was (53.21 卤11.51) D. The mean corneal endothelial cell density (endothelial cell density,ECD) was (2 413.26 卤431.29) / mm2. before operation. Results all the operations were completed successfully, there were no complications during the operation, and all corneal patches were transparent at the early stage after operation. The average follow-up time was (8.75 卤2.13) months. The mean uncorrected visual acuity (uncorrected visual acuity,UCVA) was 0. 25 卤0. 27, which was significantly different from that before operation (0. 10 卤0. 07). The average best corrected visual acuity (best corrected visual acuity,BCVA) was 0. 45 卤0. 26, which was significantly different from that before operation (0. 28 卤0. 27). The mean corneal curvature was (44. 82 卤0. 91) D. The average loss rate of ECD / mm2, endothelial cells was 2.6%, which was not significantly different from that before operation (P 0.05). Conclusion FALK has good clinical effect and safety in keratopathy.
【作者单位】：南京军区南京总医院眼科;
【基金】：国家自然科学基金(81270979) 江苏省自然科学基金(BK2012777)
【分类号】：R779.65

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