Big bubble deep anterior lamellar keratoplasty for management of deep fungal keratitis.
Big bubble deep anterior lamellar keratoplasty for management of deep fungal keratitis.
复制标题
大气泡深前板层角膜移植术治疗深部真菌性角膜炎
DOI：
10.1155/2014/209759
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发表时间：
2014
影响因子：
1.9
通讯作者：
Shi W
中科院分区：
文献类型：
--
作者：
Gao H;Song P;Echegaray JJ;Jia Y;Li S;Du M;Perez VL;Shi W
目标。目的评价大气泡深板层角膜移植治疗深部真菌性角膜炎的疗效。方法：纳入2011年7月至2012年12月在山东眼科医院就诊的深部真菌性角膜炎合并DALK的患者。所有患者的渗漏深度均超过角膜厚度的4/5。DALK手术采用大泡技术，使用裸露的后弹力膜(DM)。监测矫正远视力(CDVA)、移植物状态、术中及术后并发症。结果。23例(23只眼)行大气泡角膜切开术。基质剥离术中DM穿孔2只眼(8.7%)。患者接受了板层角膜移植，前房内注入气泡。形成双前房3眼(13.0%)。无白内障、弱视和真菌复发的患者术后平均视力由术前的HM/20 cm−1.0(LogMAR)提高到末次随访时的0.2 3±0.13(P<；0.0 1)。真菌复发2例(8.7%)。1例(4.3%)患者发生角膜基质移植排斥反应。结论。DALK使用大气泡技术治疗对药物无效的深部真菌性角膜炎似乎是有效和安全的。
Objective. To evaluate the therapeutic effect of big bubble deep anterior lamellar keratoplasty (DALK) in patients with deep fungal keratitis. Methods.Consecutive patients who had DALK for deep fungal keratitis at Shandong Eye Hospital between July 2011 and December 2012 were included. In all patients, the infiltration depth was more than 4/5ths of the corneal thickness. DALK surgery was performed with bare Descemet membrane (DM) using the big bubble technique. Corrected distance visual acuity (CDVA), graft status, and intraoperative and postoperative complications were monitored. Results. Big bubble DALK was performed in 23 patients (23 eyes). Intraoperative perforation of the DM occurred in two eyes (8.7%) during stromal dissection. The patients received lamellar keratoplasty with an air bubble injected into the anterior chamber. Double anterior chamber formed in 3 eyes (13.0%). Mean CDVA of the patients without cataract, amblyopia, and fungal recurrence was improved from preoperative HM/20 cm−1.0 (LogMAR) to 0.23 ± 0.13 (LogMAR) at the last followup (P < 0.01). Fungal recurrence was found in two patients (8.7%). Corneal stromal graft rejection was noted in one patient (4.3%). Conclusions. DALK using the big bubble technique seems to be effective and safe in the treatment of deep fungal keratitis unresponsive to medication.
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作者：
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通讯作者：
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