深板层角膜移植术与穿透角膜移植术治疗圆锥角膜效果的比较

作     者：Watson S.L. Ramsay A. Dart J.K.G. 张磊 

作者机构：Corneal and External Di seases Moorfields Eye Hospital London United Kingdom 

出 版 物：《世界核心医学期刊文摘（眼科学分册）》 (Digest of the World Core Medical Journals:Ophthalmology)

年 卷 期：2005年第1卷第2期

页      面：49-50页

学科分类：1002[医学-临床医学] 100212[医学-眼科学] 10[医学] 

主　　题：穿透角膜移植术 圆锥角膜 等量球镜 矫正视力 排斥反应 屈光力 连续缝合 眼科医院 轻度近视 尼龙线 

摘      要：Objective To compare the therapeutic outcomes after deep lamellar keratoplasty (DLK) and penetrating keratoplasty (PK)in patients with keratoconus. Design Ret rospective case-control study. Participants We reviewed the clinical notes of 4 7 patients diagnosed clinically with keratoconus who had received DLK (26 eyes o f 25 patients) or PK (25 eyes of 22 patients) at Moor-fields Eye Hospital or th e Royal Shrewsbury Hospital between 1994 and 2001. The patients in the 2 groups were matched for severity of their keratoconus by preoperative visual acuity. Me thods Deep lamellar keratoplasty was performed with the Melles technique in 7 ey es and the technique described by Sugita and Kondo in 19 eyes. Penetrating kerat oplasty was performed with a standard technique using a Hessburg-Barron trephin e. A single continuous 16-bite 10-0 nylon suture was placed and adjusted in bo th groups. Main outcome measures Best-corrected visual acuity (BCVA), refractiv e results, surgical techniques for DLK, and complication rates were analyzed. Re sults The 25 patients with keratoconus who underwent DLK had a mean age of 32.6 years and a median follow-up of 28 months. The mean age of the 22 patients who underwent PK for keratoconus was 34 years. This group was followed up for a medi an time of 55 months. The median final BCVA of patients in the DLK group was 6/9 and in the PK group 6/6 (no statistical significance). The median result for th e final spherical equivalent power in both groups was mild myopia, although the DLK group had more myopia, and the median astigmatism was less than 5.00 d iopters cylinder for both groups. Complication rates were similar for DLK and PK , although the nature of the complications varied. Conclusions Penetrating kerat oplasty is no longer an automatic choice for the surgical treatment for keratoco nus; DLK seems to be a safe alternative. Best-corrected visual acuity, refracti ve results, and complication rates are similar after DLK and PK. Deep lamellar