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目的 :观察带环形板层巩膜瓣全板层角膜移植术治疗严重眼部化学伤的临床疗效 ,探讨其免疫学机制。方法 :对 148例 (148眼 )行角膜移植术的患者进行回顾性分析 ,将 42例 (4 2眼 )行带环形板层巩膜瓣全板层角膜移植术治疗的严重眼部化学伤 ( 组 )与同期 13例 (13眼 )行全角膜移植术 ( 组 )和 93例 (93眼 )行部分穿透性角膜移植术 ( 组 )的患者进行对照 ,比较手术后角膜的透明度、新生血管出现的时间、排斥率及排斥反应出现的时间。结果 :带环行板层巩膜瓣全板层角膜移植组与全角膜移植组比较 ,角膜植片新生血管出现的时间及排斥反应出现的时间均延迟 ,排斥率下降 ,透明率明显提高。而较部分穿透性角膜移植术组半年后的排斥率明显增加 ,透明率明显下降。结论 :带环形板层巩膜瓣全板层角膜移植术是严重眼部化学伤后重建眼前节的有效方法 ,其免疫学机制复杂。术后维持泪膜的质量、综合抗排斥反应是提高手术效果的关键
Objective: To observe the clinical effect of corneal allograft corneal transplantation with annular lamellar scleral flap in the treatment of severe ocular chemical injury and to explore its immunological mechanism. Methods: A total of 148 patients (148 eyes) undergoing corneal transplantation were retrospectively analyzed. Forty-two patients (42 eyes) underwent corneal scleral flap corneal allograft lamellar keratoplasty ) Were compared with 13 patients (13 eyes) underwent corneal transplantation (group) and 93 patients (93 eyes) underwent partial penetrating keratoplasty (group) during the same period. The corneal transparency and neovascularization were compared The time of rejection, the rate of rejection and the time of rejection. Results: Compared with the whole corneal transplantation group, the time of neovascularization of corneal graft and the time of rejection appeared delayed, the rejection rate decreased and the transparency increased obviously. However, the rejection rate of the partially penetrating keratoplasty group increased significantly after six months and the transparency decreased significantly. Conclusion: The whole lamellar keratoplasty with annular lamellar scleral flap is an effective method to reconstruct the anterior segment of eye after severe ocular chemical injury. The immunological mechanism is complex. Postoperative tear film to maintain the quality of comprehensive anti-rejection reaction is to improve the surgical effect of the key