[1]李上,臧云晓,张薇,等.穿透性角膜移植联合白内障摘出及人工晶状体植入术疗效观察[J].眼科新进展,2018,38(4):344-347.[doi:10.13389/j.cnki.rao.2018.0080]
　LI Shang,ZANG Yun-Xiao,ZHANG Wei,et al.Clinical observation of a triple procedure of stimultaneous penetrating keratoplasty combined with extracapsular cataract extraction and intraocular lens implantation[J].Recent Advances in Ophthalmology,2018,38(4):344-347.[doi:10.13389/j.cnki.rao.2018.0080]
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穿透性角膜移植联合白内障摘出及人工晶状体植入术疗效观察/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
38卷
期数:
2018年4期
页码:
344-347
栏目:
应用研究
出版日期:
2018-04-05

文章信息/Info

Title:
Clinical observation of a triple procedure of stimultaneous penetrating keratoplasty combined with extracapsular cataract extraction and intraocular lens implantation
作者:
李上; 臧云晓; 张薇; 董宏伟; 郭纯刚; 卢红双; 潘志强; 接英
100069　北京市，首都医科大学附属北京佑安医院眼科（李上，张薇，董宏伟，郭纯刚）；100730　北京市，首都医科大学附属北京同仁医院北京同仁眼科中心（臧云晓，卢红双，潘志强，接英）
Author(s):
LI Shang; ZANG Yun-Xiao; ZHANG Wei; DONG Hong-Wei; GUO Chun-Gang; LU Hong-Shuang; PAN Zhi-Qiang; JIE Ying
Department of Ophthalmology，Beijing Youan Hospital，Capital Medical University （LI Shang，ZHANG Wei，DONG Hong-Wei，GUO Chun-Gang），Beijing 100069，China；Beijing Tongren Eye Center，Beijing Tongren Hospital，Capital Medical University （ZANG Yun-Xiao，LU Hong-Shuang，PAN Zhi-Qiang，JIE Ying），Beijing 100730，China
关键词:
穿透性角膜移植术; 白内障囊外摘除术; 三联手术
Keywords:
penetrating keratoplasty; extracapsular cataract extraction; triple procedure
分类号:
R779.6
DOI:
10.13389/j.cnki.rao.2018.0080
文献标志码:
A
摘要:
目的　评价同时行穿透性角膜移植、白内障囊外摘出联合人工晶状体植入术（简称三联手术）患者的手术效果，探讨三联手术术后角膜屈光力与术前晶状体度数的选择。方法　回顾性分析2016年4月至10月在北京佑安医院行三联手术的15例患者资料，观察患者术后1 a的最佳矫正视力（best corrected visual acuity，BCVA）、眼压、角膜屈光度、眼轴长度、并发症及角膜内皮细胞数以及植片存活情况。结果　所有患者术后1 a角膜植片均保持透明，角膜内皮细胞数为（1974.20±472.82）个·mm-2。术后BCVA为(0.80±0.27）LogMAR，与术前（2.63±0.62）LogMAR相比，有显著性提高（t=13.042，P<0.001）。术后眼压为（14.53±3.04）mmHg（1 kPa=7.5 mmHg），与术前眼压（15.27±2.37）mmHg相比，差异无统计学意义（t=0.685，P=0.505）。术后眼轴长度为（23.62±2.12）mm，与术前（23.69±2.01）mm相比，差异无统计学意义（t=-0.138，P=0.893）。术后角膜屈光度为（42.56±5.48）D，与术前对侧眼（45.01±1.66）D相比，差异无统计学意义（t=1.202，P=0.260）。术前目标屈光度为（0.58±0.25）D，术后等效球镜度为（0.40±4.65）D。结论　三联手术对于治疗伴有白内障的角膜疾病是一种安全有效的手术方式，术前选择预留偏正视的晶状体度数可能获得满意的术后视力，但术后不可预知的角膜曲率改变仍会对屈光状态造成影响。
Abstract:
Objective　To evaluate the operative outcomes of a triple procedure including simultaneous penetration keratoplasty (PKP)，extracapsular cataract extraction (ECCE) and intraocular lens (IOL) implantation，and to investigate the relationship between postoperative corneal refractive power and preoperative lens diopter.Methods　This retrospective analysis study involved 15 patients who had undergone a triple procedure surgery in Beijing You’an hospital from April to October 2016.Outcomes including the best corrected visual acuity (BCVA)，intraocular pressure (IOP)，corneal refractive power，axial length，postoperative complications，corneal endothelial cell counts and the survival of corneal graft were determined one year after surgery.Results　All corneal grafts were transparent and corneal endothelium were (1974.20±472.82)cell·mm-2.The mean postoperative LogMAR visual acuity (0.80±0.27) had a significant improvement compared with the mean preoperative LogMAR visual acuity (2.63±0.62) (t=13.042，P<0.001).There were no statistically significant differences in preoperative IOP (15.27±2.37)mmHg (1 kPa=7.5 mmHg) and postoperative data (14.53±3.04)mmHg (t=0.685，P=0.505)，preoperative axial length (23.69±2.01) mm and postoperative data (23.62±2.12)mm (t=-0.138，P=0.893) and preoperative keratometry (45.01±1.66) D of the control eye and postoperative data (42.56±5.48) D (t=1.202，P=0.260).The postoperative spherical equivalent refractive was (0.40±4.65) D，and the target refraction was (0.58±0.25)D.Conclusion　The triple procedures are safe and effective for the treatment of patients with coexisting corneal pathologies and cataracts.Selection of emmetropia lens diopter may result in the satisfactory postoperative visual acuity.However，unpredictable postoperative corneal curvature changes will still affect the final refractive state.

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备注/Memo

备注/Memo:
国家自然科学基金资助（编号：81170824）；北京市自然科学基金资助（编号：7182037）；卫生系统高层次卫生技术人才培养计划课题基金资助（编号：2013-3-055）
更新日期/Last Update: 2018-04-02