论文部分内容阅读
目的对深板层角膜移植术(DLK)和穿透性角膜移植术(PK)两种术式治疗圆锥角膜的疗效进行比较。方法将我院2001-2004临床诊断明确的圆锥角膜患者47人(58眼)随机分为2组,分别行深板层角膜移植术(25人,30眼,平均年龄28.6岁,平均术后随访时间28个月)和穿透性角膜移植术(22人,28眼,平均年龄31岁,平均术后随访时间36个月)。术前检查两组患者视力并验光,术后分析最佳矫正视力、屈光度变化和并发症。结果两组患者术后的视力变化无统计学差别(P>0.05),2组术后均表现为轻度近视,但深板层角膜移植组近视较重;2组平均散光均低于5.00DC;深板层角膜移植组排斥反应的发生较穿透性角膜移植组低(P<0.05)。结论深板层角膜移植术比穿透性角膜移植术并发症少,它能减少内皮型排斥反应的发生,且术后最佳矫正视力、屈光度与穿透性角膜移植术近似,手术失败的发生率低,穿透性角膜移植术不再是治疗圆锥角膜的首选术式。
Objective To compare the effects of deep lamellar keratoplasty (DLK) and penetrating keratoplasty (PK) on keratoconus. Methods Forty-seven patients (58 eyes) with clinically clear keratoconus in our hospital from 2001 to 2004 were randomly divided into two groups. They were treated with deep lamellar keratoplasty (25 men and 30 eyes, mean age 28.6 years, mean follow-up Time 28 months) and penetrating keratoplasty (22 patients, 28 eyes, mean age 31 years, with an average follow-up of 36 months). Preoperative examination of both groups of patients with visual acuity and optometry, postoperative analysis of the best corrected visual acuity, diopter changes and complications. Results There was no significant difference in postoperative visual acuity between the two groups (P> 0.05). Both groups showed mild myopia postoperatively, but severe myopia was found in the deep lamellar keratoplasty group. The average astigmatism in both groups was lower than 5.00 DC The incidence of rejection in deep lamellar keratoplasty was lower than that in penetrating keratoplasty (P <0.05). Conclusions Deep lamellar keratoplasty has fewer complications than penetrating keratoplasty, which can reduce the occurrence of endothelial rejection. The optimal corrected visual acuity, refractive power and penetrating keratoplasty are similar, and the operation fails Low rate, penetrating keratoplasty is no longer the preferred surgical treatment of keratoconus.