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目的 :评价自体转位角膜移植 (rotationalautokeratoplasty ,RAP)的疗效。方法 :对 2 1例 (2 1只眼 )角膜白斑的患者实施RAP ,观察手术前后视力和植片的变化 ,并对手术和术后并发症进行探讨。结果 :平均随访时间 13 1个月 ,8例 (8只眼 )仅实施RAP ,其余 13例 (13只眼 )除实施RAP外还联合白内障摘出、人工晶状体植入、瞳孔成形以及玻璃体切割术。术后视力比术前明显提高 ,所有植片中央区透明 ,未见新生血管侵入植片。 1例发生吻合口渗漏 ,重新缝合后愈合良好。 5例出现高眼压 ,其中 3例用抗青光眼药物眼压控制正常 ,2例眼压自行恢复正常。结论 :RAP术后不发生排斥反应 ,增视效果较明显 ,对于角膜中央白斑和某些高危病例是一种有效的治疗方法。
Objective: To evaluate the efficacy of rotationalautokeratoplasty (RAP). Methods: RAP was performed in 21 patients (21 eyes) with corneal leukoplakia. The visual acuity and the changes of the grafts were observed before and after surgery. The surgical and postoperative complications were also discussed. Results: The average follow-up time was 13 months. Eight patients (8 eyes) performed only RAP. The remaining 13 patients (13 eyes) were treated with RAP together with cataract extraction, intraocular lens implantation, pupil formation and vitrectomy. Postoperative visual acuity was significantly improved compared with preoperative, all the central area of the graft transparent, no neovascular invasion of implants. 1 case of anastomotic leakage, re-suture healed well. 5 cases of ocular hypertension, of which 3 cases with anti-glaucoma control of normal intraocular pressure, 2 cases of intraocular pressure to return to normal on their own. Conclusion: RAP does not occur after rejection reaction, increasing the apparent effect of more obvious for the central corneal leukoplakia and some high-risk cases is an effective treatment.