双泡技术在深板层角膜移植手术中的应用.pdfVIP

双泡技术在深板层角膜移植手术中的应用 高明宏 陈颖欣 [摘要]目的 评价双气泡技术在深板层角膜移植手术中应用的有效性。方法 对35例 （37只眼）内 皮功能正常的角膜基质病变病人，采用以前房内小气泡引导基质内注入大气泡成功分离后弹力膜的双泡 技术进行深板层角膜移植术，分析手术技巧，观察术后最佳矫正视力及并发症。结果 30只眼(81.1％)采 用双泡技术成功完成后弹力膜分离；5只眼(13.5％)术中发生后弹力膜微穿孔，继续完成手术；2只眼 (5.4％)因后弹力膜穿孔范围较大而改行穿透性角膜移植术。随访6～18(平均12.3)个月，术后平均最佳矫 正视力为0.47±0.17(0.1～0.8)。术后并发症：4只眼(10.8％)假前房 （层间分离）,经前房内注入空气泡顶 压后治愈；3只眼(8.1％)激素相关性眼压升高；4只眼(10.8％)排斥反应，均经相应的药物治疗治愈。结论 双泡技术能显著提高角膜后弹力膜完全分离的成功率，并能缩短手术时间,提高手术质量，是深板层角 膜移植手术技巧中较为安全有效的一种技术。 双气泡技术；角膜移植；后弹力膜 Doublebubbletechniqueindeeplamellarkeratoplastysurgery GAOMing-hongCHENYing-xinDepartmentofOphthalmology,theGeneralHospitalofShenyang MilitaryCommand,Shenyang110840,China [Abstract] ObjectiveToevaluatetheeffectivenessofdouble-bubbletechniqueindeeplamellar keratoplasty.MethodsSmallairbubbleswereinjectedintoanteriorchamberforaguidebeforeinjec tionoflargeairbubbleswithinthematrixtoseparateDescemetsmembranein35patients (37eyes) ofnormalendothelialfunctionwithcornealdiseases.Then,thebestcorrectedvisualacuityandcom plicationswereobserved,andthesurgicaltechniqueswereanalyzedatlast. ResultsTheDescemets membraneof30eyes(81.1％)weresuccessfullyseparatedbydouble-bubbletechnique,5eyes(13.5％) werealsoachievedsuccesswithmicroperforationoftheDescemetsmembrane,2eyes(5.4％)weredi vertedtopenetratingkeratoplastyduetolargerangeofperforationoftheDescemetsmembrane.The meanpostoperativebestcorrectedvisualacuitywas0.47± 0.17 (0.1～0.8)infollow-upof6to18 (mean12.3)months.Thefalseanteriorchamber (layerseparation)of4eyes (10.8％)werecuredby injectionofairbubblestotheappropriatepressure,3eyes (8.1％)ofhormone-relatedelevationofin traocularpressureand4eyes (10.8％)ofimmunerejectionwereallcuredbydrugtreatment. Con clusionsDouble-bubbletechniquecansignificantlyimprovethesuccessrateofcornealDescemets membraneseparationandcanshortentheoperativetimeandimprovethequalityofoperation.Dou ble-bubbletechniqueisakindofsafeandeffectivesurgicaltechniqueondeeplamellarkeratoplasty.