穿透性角膜移植联合后房型人工晶体缝线固定术的临床观察

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目的:随着眼科显微手术及人工晶体植入术的发展,穿透性角膜移植(penetratingkeratoplasty,PKP)联合人工晶体植入术已成为可行,但对于后囊膜破裂或无支撑力的后囊是否植入前房型人工晶体或缝线固定的后房型人工晶体尚无定论。我们探讨 PKP 联合后房型人工晶体缝线固定术的临床效果及影响因素。方法:采用 PKP 联合睫状沟缝线固定的后房型人工晶体值入术,对不同病因所致的角膜混浊14例(14只眼)进行治疗,术后随访3个月至2年。结果:术后3个月植片透明率78.6%,6个月透明率为71.4%,12个月透明率为57.1%。术后视力改善12只眼,占85.7%,术后脱盲率为64.4%。术后并发症主要为排斥反应(21.4%),继发性青光眼(21.4%)。结沦:PKP 联合后房型人工晶体缝线固定一次性手术,可避免多次手术的痛苦,手术效果较满意,术后并发症少,对于重建前节以及增视、美容方面均具有重要意义。 OBJECTIVE: With the development of ophthalmic microsurgery and intraocular lens implantation, penetrating keratoplasty (PKP) combined with intraocular lens implantation has become feasible. However, for posterior capsular rupture or unsupported posterior capsule Whether the implantation of anterior chamber intraocular lens or suture fixed posterior chamber intraocular lens is inconclusive. We explore the PKP combined with posterior chamber intraocular lens suture fixation of the clinical effect and influencing factors. Methods: The posterior chamber intraocular lens (PVP) combined with ciliary sulcus suture fixation was used to treat 14 cases (14 eyes) of corneal opacity caused by different etiologies. The patients were followed up for 3 months to 2 years. Results: At 3 months after operation, the transparency of the grafts was 78.6%. The transparency rate at 6 months was 71.4%. The transparency rate at 12 months was 57.1%. Postoperative visual acuity improved in 12 eyes, accounting for 85.7%, postoperative blindness rate was 64.4%. Postoperative complications were mainly rejection (21.4%) and secondary glaucoma (21.4%). Conclusions: PKP combined posterior chamber intraocular lens suture fixation of a one-time surgery to avoid the pain of multiple surgeries, surgical results are satisfactory, less postoperative complications, for reconstruction of anterior segment and hyperopia, cosmetic aspects are of great significance.
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