本文選題：角膜交聯(lián)術(shù) + 進(jìn)展期圓錐角膜�。� 參考：《眼科》2017年05期

【摘要】：目的總結(jié)角膜交聯(lián)術(shù)治療進(jìn)展期圓錐角膜的并發(fā)癥。設(shè)計(jì)回顧性病例系列。研究對(duì)象2015年1-12月北京同仁醫(yī)院收治的進(jìn)展期圓錐角膜患者40例(40眼)。方法回顧性分析患者術(shù)后臨床資料,術(shù)前含上皮最薄角膜厚度在375~450μm,行去上皮角膜交聯(lián)術(shù)。術(shù)后1天、3天、1周、1個(gè)月通過(guò)問(wèn)卷調(diào)查對(duì)患者疼痛感及異物感程度進(jìn)行評(píng)估,并行眼前節(jié)檢查。主要指標(biāo)患者治療前后視力、眼壓、眼部疼痛程度、角膜上皮修復(fù)及角膜水腫情況。結(jié)果患者術(shù)后1天存在明顯疼痛感(3.19±0.37分)與異物感(3.15±0.23分),可見(jiàn)部分角膜上皮缺損,術(shù)后3天患者異物感(2.23±0.43分)與疼痛(2.23±0.32分)感明顯減輕,且角膜上皮大部分修復(fù);術(shù)后1周,所有患者僅有輕微異物感(0.23±0.07分)及疼痛(0.22±0.11分),角膜上皮基本修復(fù)。術(shù)后1個(gè)月患者無(wú)明顯異物感及疼痛感。隨訪6個(gè)月,40例患者病情均得到控制,30例患者術(shù)后復(fù)查裸眼視力均有不同程度提高,35例患者矯正視力有明顯提高,無(wú)角膜感染、瘢痕、潰瘍、上皮缺損等并發(fā)癥發(fā)生。結(jié)論角膜膠原交聯(lián)術(shù)治療進(jìn)展期圓錐角膜效果好,主要并發(fā)癥是術(shù)后早期疼痛及角膜上皮缺損。
[Abstract]:Objective to summarize the complications of corneal crosslinking in the treatment of advanced keratoconus. Design retrospective case series. Participants 40 patients with advanced keratoconus admitted to Tongren Hospital in Beijing from January to December 2015 were treated with 40 eyes of keratoconus. Methods retrospective analysis of postoperative clinical data showed that the thinnest corneal thickness was 375 渭 m. The degree of pain and foreign body sensation was evaluated by questionnaire, and the anterior segment was examined. Main outcome measures visual acuity, intraocular pressure, degree of ocular pain, corneal epithelial repair and corneal edema before and after treatment. Results there were significant pain (3.19 鹵0.37) and foreign body (3.15 鹵0.23) and partial corneal epithelial defects (2.23 鹵0.43) and 2.23 鹵0.32 (2.23 鹵0.32) and most of corneal epithelium were repaired 1 week after operation. All the patients had only slight foreign body sensation (0.23 鹵0.07) and pain (0.22 鹵0.11), and the corneal epithelium was basically repaired. One month after operation, there was no obvious foreign body sensation or pain in the patients. All 40 patients were controlled for 6 months. After operation, the uncorrected visual acuity was improved significantly in 35 patients. There were no complications such as corneal infection, scar, ulcer, epithelial defect and so on. Conclusion Corneal collagen crosslinking is effective in the treatment of advanced keratoconus. The main complications are early postoperative pain and corneal epithelial defect.
【作者單位】： 首都醫(yī)科大學(xué)附屬北京同仁醫(yī)院北京同仁眼科中心眼科學(xué)與視覺(jué)科學(xué)北京市重點(diǎn)實(shí)驗(yàn)室;
【分類號(hào)】：R779.6

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