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目的 :探讨穿透性角膜移植术 (PKP)后的角膜形状改变以及如何进行屈光矫正。方法 :观察最近四年施行PKP后要求进行光学矫正的圆锥角膜 2 5例、2 6只眼 ,角膜穿通伤、外伤性白内障术后无晶状体、虹膜损伤 3例 3只眼的术后屈光状态 ,角膜地形图的改变 ,屈光矫正的种类和方法 ,视力矫正效果 ,以及部分病例戴镜后的复诊观察。结果 :PKP后～戴镜矫正时间平均 2 1± 2 6 5个月 ,缝线拆除后戴镜矫正时间平均 3 1± 4 5个月。角膜曲率仪测定弱主径线值 (FK)平均 44 43±4 91D ,强主径线值 (SK)平均 5 0 98± 5 73D ,相对应的角膜地形图两个数值 (Simk)平均 44 73± 4 93D和 5 1 85± 6 0 3D ,两组间无显著性差异。SRI平均 2 82± 1 5 9,SAI平均 2 5 6± 1 2 8。 2 4只眼配戴RGPCL(透气性硬镜角膜接触镜 ) ,两只眼配戴Piggybacklens ,一只眼用框架眼镜矫正 ,两只眼未能矫正。术后 2 6只眼近视 - 4 94± 3 95D ,近视散光 - 4 79± 2 0 9D ,3只无晶状体眼为远视散光。RGPCL矫正视力 6 1 5 %可达 0 8～ 1 5 ,框架眼镜仅为 2 1 4%。 9只眼经复诊观察 ,散光度降低2 0 0D～ 5 0 0D ,近视度降低 1 0 0D～ 3 0 0D ,角膜内皮细胞密度无显著性变化。SRI与SAI值均比戴镜前显著降低。无充血、炎症、感染、免疫排?
Objective: To investigate the corneal shape changes after penetrating keratoplasty (PKP) and how to perform refractive correction. Methods: 25 cases of keratoconus requiring optical correction after PKP were performed in the last four years, 26 eyes were treated with corneal penetrating injury, aphakia after traumatic cataract surgery, 3 cases of iris injury in 3 eyes. Postoperative refractive status , Changes in the topography of the cornea, types and methods of refractive correction, visual acuity correction, and follow-up observation after wearing glasses in some cases. Results: After PKP ~ wearing glasses correction time average 21 ± 265 months, wearing glasses after wearing glasses correction time average 31 ± 45 months. Corneal curvature instrument measured the average value of the primary major axis (FK) 44 43 ± 4 91D, the average value of the major major axis (SK) 5898 ± 5 73D and the corresponding corneal topography (Simk) averaged 44 73 ± 4 93D and 5 1 85 ± 6 0 3D, no significant difference between the two groups. The average SRI was 82 82 ± 159, and the SAI was 256 568. 2 Eyes were worn with RGPCL (gas permeable hardcopy contact lenses), Piggybacklens was worn on both eyes, one eye was corrected with eye glasses, and both eyes were unable to correct. Myopia - 4 94 ± 3 95D, myopic astigmatism - 4 79 ± 2 0 9D were observed in 26 eyes after operation, and myopic astigmatism was observed in 3 patients with aphakia. RGPCL corrected visual acuity 6 1 5% up to 0 8 ~ 1 5, frame glasses only 2 1 4%. In 9 eyes, the corneal endothelial cells showed no significant changes in the astigmatism after the follow-up examination. The astigmatism decreased from 200D to 500D, and the degree of myopia decreased from 100D to 300D. SRI and SAI values were significantly lower than before wearing glasses. No congestion, inflammation, infection, immune regulation?