山东大学耳鼻喉眼学报

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角膜弹性半球定律指导下的穿透角膜移植屈光控制

蒋 华,张 霞,高洪瑞,魏 捷,路振莉,王光洁   

  1. 第二军医大学济南临床医学院 济南军区总医院眼科暨军区眼科中心, 济南 250031
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2008-04-24 发布日期:2008-04-24
  • 通讯作者: 蒋 华

Penetrating keratoplasty refraction control directed by the corneal refractive law of the springy hemisphere

JIANG Hua, ZHANG Xia, GAO Hong-rui, WEI Jie, LU Zhen-li, WANG Guang-jie   

  1. Department of Ophthalmology, Jinan Clinical Medical College of Second Military Medical University,General Hospital of Chinese PLA, Jinan Command, Jinan 250031, China
  • Received:1900-01-01 Revised:1900-01-01 Online:2008-04-24 Published:2008-04-24
  • Contact: JIANG Hua

摘要: 目的评价角膜弹性半球定律指导下的角膜屈光控制技术对穿透性角膜移植术(PKP)后屈光控制的效果。方法对角膜病患者68例(85眼)按光学移植要求行PKP术。根据角膜弹性半球定律选择性拆线,1、3、6、12个月及拆线后3、6个月行视力、角膜曲率、角膜地形图及屈光检查。结果术后15个月裸眼视力≥0.5者59眼,其中20眼视力≥1.0,0.3~0.5者21眼。拆线前角膜屈折力(37.35±3.64)D,拆线后最终角膜屈折力(43.52±2.25)D, 差异有统计学意义(P<0.05)。首次拆线前平均角膜散光(4.83±4.16)D,术后15个月(1.97±2.69)D,差异有统计学意义(P<0.01)。等效球镜术后1个月与3、6、12、15个月差异有统计学意义(P<0.05),术后15、18个月之间差异无统计学意义(P>0.05)。结论在角膜弹性半球定律指导下,选择性拆线结合其他技术可以控制和改善角膜移植术后屈光状态。

关键词: 角膜移植术, 穿透性, 屈光控制, 角膜弹性半球定律

Abstract: To evaluate the refractive efficacy of penetrating keratoplasty(PKP)following refraction control directed by the corneal refractive law of the springy hemisphere. MethodsPKP was performed on 85 eyes of 68 patients. The sutures were selectively detached directed by the corneal refractive law of the springy hemisphere. Visual acuity, corneal curvature and spherical equivalent were determined before and 1,3,6,12 and 15 months after the operations. Results15 months after the operations, the mean uncorrected visual acuity of 59 eyes was ≥0.5 and of 20 eyes ≥1.0. The mean corneal curvature was 37.26±2.85D before the first suture removal and was 43.52±2.25D after all suture removal (P<0.05). The mean corneal astigmatism was 4.83±4.16D before the suture removal and was 1.97±2.69D 15 months after the operations (P<0.01). The spherical equivalent of the corneas was different between post-operative 1 month and post-operative 3,6,12 and 15 months (P<0.05), also it was statistically different between post-operative 15 months and 18 months (P>0.05). ConclusionSuture removal selectively directed by the corneal refractive law of the springy hemisphere combined with other techniques can reduce post-operative refractive errors, improve visual acuity and control post-operative visual performance.

Key words: penetrating, Refraction, Keratoplasty, Corneal refractive law of the springy hemisphere

中图分类号: 

  • R779.65
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