目的:观察圆锥角膜患者行深板层角膜移植和穿透角膜移植术后视力、角膜曲率及角膜内皮细胞的变化。方法:将2003-01/2009-07在我院行手术治疗的42例47眼圆锥角膜患者分为两组,一组接受深板层角膜移植(27眼),另一组接受穿透角膜移植(20眼)。观察两组患者术后3,6,12,18mo的裸眼视力、最佳矫正视力、角膜地形图改变和角膜内皮细胞状态。结果:深板层角膜移植组术后裸眼视力平均提高4行,最佳矫正视力平均提高7行,无排斥反应发生。穿透角膜移植术后裸眼视力平均提高5行,最佳矫正视力平均提高8行,有5例发生排斥反应。两种术式相比,术后散光程度无明显差异,深板层角膜移植组角膜内皮细胞丢失速率低于穿透角膜移植组。结论:对于非急性期圆锥角膜患者深板层角膜移植术优于穿透角膜移植术。

AIM:To observe the changes of visual acuity,keratometry values and corneal endothelial cells after deep lamellar keratoplasty or penetrating keratoplasty in keratoconus patients.METHODS:The keratoconus patients who accepted operations from January 2003 to July 2009 were divided into two groups:one group accepted deep lamellar keratoplasty(27 eyes),the other group accepted penetrating keratoplasy(20 eyes).Postoperative uncorrected visual acuity,best corrected visual acuity,corneal topography changes and corneal endothelial cells were observed.RESULTS:In deep lamellar keratoplasty group,postoperatively the patients saw 4 lines more with no correction,7 lines more with best correction and there was no rejection.In penetrating keratoplasty group,postoperatively the patients saw 5 lines more with no correction,8 lines more with best correction and there were five patients had rejection.There were no difference in astigmatism degree after keratoplasty between the two groups.The speed of decline of corneal endothelial cells in deep lamellar keratoplasty group was lower than that of penetrating keratoplasty group.CONCLUSION:For unacute keratoconus,deep lamellar keratoplasty is better than penetrating keratoplasty.

R779.65