同济大学学报（医学版）2018，Vol.39Issue(3)：53-58,6.DOI:10.16118/j.1008-0392.2018.03.010
深板层角膜移植术后白内障手术的临床研究
Cataract extraction and intraocular lens implantation after deep anterior lamellar keratoplasty
摘要
Abstract
Objective To evaluate the safety and efficacy of cataract extraction and intraocular lens implantation after deep anterior lamellar keratoplasty ( DALK). Methods Thirty-four patients ( 34 eyes) with cataract were treated with phacoemulsification and intraocular lens implantation ( IOL) after DALK ( DALK group ) , whereas 35 patients ( 35 eyes ) with simple senile cataract undergoing phacoemulsification and IOL served as control group. Corneal astigmatism was measured with corneal topographic map. Endothelial cell density ( ECD) and average cell area ( ACA) were obtained with confocal microscopy. Central corneal thickness(3 mm CCT) and anterior chamber depth( ACD) were analyzed by anterior segment optical coherence tomography ( AS-OCT ). Patient with corneal astigmatism＞1. 5D underwent astigmatic keratotomy ( AK ) during phacoemulsification and IOL implantation. Results All the operations were performed successfully and patients were followed-up for ( 13. 1 ± 1. 5) months. There was no significant differences in UCVA, BCVA, CCT and ACD between DALK group and control group before operation, while there were significant differences in preoperative A, CA, ECD, ACA between two groups. Twelve months after the surgery, UCVA and BCVA were significantly improved in both groups, but the improvement was more marked in control group ( P＜0. 05). The A, CA and ECD decreased after surgery in both groups, while the decrease was more marked in DALK group ( P＜0. 05). The ACA was increased in both groups after surgery,the degree of increase in DALK group was more marked than that in control group ( P＜0. 05).The ACD of the two groups increased after surgery( P＜0. 05). There was no significant difference in CCT before and 12 months after surgery in two groups( P＞0. 05). Conclusion For patients undergoing cataract extraction and IOL after DALK, more attentions should be paid to corneal astigmatism correction and protection of ECD and corneal graft during the surgery.关键词
深板层角膜移植术/晶体超声乳化术/角膜内皮细胞密度/角膜源性散光/人工晶体屈光力计算Key words
deep anterior lamellar keratoplasty/phacoemulsification/endothelial cell density/corneal astigmatism/intraocular lens power calculation分类
医药卫生引用本文复制引用
张娟,王桑桑,黄心瑜,牛国桢,张语珊,毕燕龙..深板层角膜移植术后白内障手术的临床研究[J].同济大学学报（医学版）,2018,39(3):53-58,6.基金项目
国家自然科学基金(81470028) （81470028）
上海市2016年度"科技创新行动计划"(16140900900) （16140900900）
