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目的 评价复杂性角膜混浊患者行人工角膜植入术的临床效果和并发症等。方法选择 1 5例双眼盲目患者的单侧眼 1 5只 ,术前视力均为光感 ,角膜混浊病变无法用常规角膜移植手术达到复明目的。其中严重碱烧伤 6只眼 ,严重酸烧伤 3只眼 ,铝水烧伤 2只眼 ,爆炸伤 1只眼 ,严重实质性眼干燥症 1只眼 ,多次穿透性角膜移植失败角膜严重血管化 2只眼。人工角膜 (MICOF )由俄罗斯费德洛夫眼外科中心制造。手术分两期 :一期手术将人工角膜支架植入角膜层间 ,选择病例行角膜表面或层间加固性手术。约 3个月后行二期手术 ,植入带螺纹的人工角膜光学部。常规行晶状体、部分虹膜及前部玻璃体切除术 ,将外 1 3上、下睑缘做永久性缝合。对完全睑球粘连者 ,用上、下睑皮肤覆盖角膜表面 ,仅暴露人工角膜光学部。结果 二期术后观察 4～ 2 6个月 ,平均 9 5个月 ,除 1只眼视力光感外 ,其余眼裸眼视力 0 1 2～ 1 0。手术并发症包括分离角膜板层时穿入前房 ,晶状体皮质残留 ,柱镜前表面结膜上皮遮盖 ,柱镜前表面纤维增生组织遮盖 ,柱镜后壁沉着物 ,角膜溶解。结论人工角膜特别适合于穿透性角膜移植难于成功的双眼盲目者 ,而且是对目前严重角膜瘢痕血管化、严重眼睑或泪液功能不良患者有效的复明手段。该术式结合自体结膜遮盖?
Objective To evaluate the clinical effects and complications of artificial corneal implantation in complex corneal opacity patients. Methods Fifteen unilateral eyes of 15 blind patients with binocular eyes were selected. The preoperative visual acuity was light sensation, and corneal opacity could not be reconstructed by conventional corneal transplantation. Severe alkali burns in 6 eyes, severe acid burns in 3 eyes, aluminum water burn in 2 eyes, blast injury in 1 eye, severe substantive xerophthalmia in 1 eye, multiple penetrating keratoplasty failure and corneal serious vascularization 2 eyes. The artificial cornea (MICOF) is manufactured by the eye care center in Federov, Russia. Surgery divided into two phases: a surgical corneal scaffold implantation corneal layer, select the corneal surface or layer reinforcement surgery. About 3 months after the second line of surgery, implanted with a threaded artificial corneal optics. Conventional lens, part of the iris and anterior vitrectomy, outside the upper and lower eyelid to do a permanent suture. For complete symblepharon, with the upper and lower eyelid skin covering the corneal surface, exposing only the corneal optics. Results The second postoperative observation of 4 ~ 26 months, an average of 95 months, with the exception of one eye light perception, the rest of the naked eye visual acuity 0 1 2 ~ 1 0. Surgical complications include penetrating the anterior chamber when the corneal lamina is separated, residual cortical tissue, epithelial conjunctival epithelium covering the anterior surface of the lenticular lens, fibrous hyperplasia tissue covering the anterior surface of the lenticular lens, posterior wall semblance of the lenticular lens, and corneal lysis. Conclusions The artificial cornea is particularly suitable for blind eyes who are difficult to be successful in penetrating keratoplasty. It is also an effective method of recanalization of patients with severe corneal scar vascularization, severe eyelid or tear dysfunction. The surgery combined with self-conjunctiva cover?