人工水晶體疱狀角膜症之角膜移植

Penetrating Keratoplasty in Pseadophakic Bullous Keratopathy

陳媚音(May Yeun Chan) ； 陳德照(Te-Tsaw Chen) ； 魏港生(Gang-Sheng Wei)

《中華民國眼科醫學會會刊》 27卷2期 (1988/05) Pp. 586-590

https://doi.org/10.30048/ACTASOS.198805.0106

摘要

本文報告本院早年因白內障手術置入人工水晶體引起疱狀角膜症之13位接受角膜移種的病例，收集時間為1983年9月至1986年7月，白內障手術大部份為囊內摘除，水晶體主要為前房Leiske lens及iris-clip lens，手術過程中沒有使用Healon。這些病例在手術後較易發生前房不穩定，眼內震盪或暫歇性內皮接觸等併發症而導致內皮細胞進行性喪失。13病例中為10男3女，平均年齡67歲（49~80歲）從人工水晶體置入至角膜代償不全發生期間平均為2年，經過平均19個月的追蹤檢查，13例中9例角膜透明，4例失敗一一其中2例為捐贈者品質欠佳，屬原發性反敗，另l例因排斥，1例因進行性前周邊黏連導致青光眼而失敗。成功9例中視力1.0者1人，0.6者1人，0.5者2人，0.4者2人，0.2者2人，不明者1人（出國）對於角膜移植時人工水晶體的處理態度，作者以為：紅彩固定水晶體一律嚴格取出，Leiske前房水品體也儘量取出，若再五入水晶體，有晶體後囊，能置入後房水晶體最好，否則本文建議置入一體成形，防紫外線及穩定性高的Interflex lens，經過一段時間的追蹤觀察，結果令人滿意。

並列摘要

13 cases of pseudophakic bullous Keratopathy had received penetrating Keratoplasty from September 1983 to July 1986. Most of the Previous Cataract surgery was ICCE with ACL (leiske lens) or iris-clip lens. All the Cataract Surgery was performed without Healon protection. There were 10 males and females, age from 49 to 80. The average inteval between inplant surgery to corneal decompensation was 2 years. After 19 months follow up, 9 cases (70%) had clear graft and 4 cases graft failure. 2 cases were primary failure with persistent graft edema due to poor donor quality. The two other failure cases was one due to rejection and one due to progression PAS and glaucoma.
The vision of the Success 9 cases was 1.0 (1 case), 0.6 (1 case), 0.5 (2 cases), 0.4 (2 cases), 0.2 (2 cases) and unknown (1 case).
Author suggest that during implant surgery, if the original IOL is iris-clip lens or Leiske Lens, remove it. Select PC lens implantation if the capsule bag intact others flexible ACL.

並列關鍵字

Pseudophakic Bullous Keratopathy ； Corneal decompensation ； Intermittent touch Syndrome ； Endothalmodonesis