Clinical Analysis Of Corneal Transplant Surgery For Complicated Corneal Diseases

BackgroundCorneal transplant surgery as a way of resolving important surgery for diseases of the cornea in the treatment of many types of corneal disease has achieved good results. While for body sources shortage, surgery Hou complications especially exclusion reaction on treatment effect has must of effects, but, as in recent years China around eye library of development, corneal transplant surgery experience of constantly accumulated, surgery technology of constantly progress, corneal save material of improved, corneal transplant devices of constantly development, immune exclusion reaction of in-depth research, corneal transplant surgery has became a treatment corneal disease of very mature of technology, success rate greatly improve, complications get good of control, Success lifted the suffering of countless patients with corneal disease.Objectives and MethodsTSelect Eye hospital in corneal disease and corneal transplant surgery can be regular follow-up in April2008and November2013108patients (108,85penetrating keratoplasty, lamellar keratoplasty23). For various reasons, which caused36 walleye, infectious corneal disease25(13fungal corneal ulcer, corneal ulcer five bacterial, viral keratitis7), bullous keratopathy17, eroded corneal ulcer3systemic autoimmune disease associated with corneal ulcers4,7keratoconus corneal chemical injury12, corneal tumors4. Male65cases, female43cases. Ages1-65years old.108patients underwent preoperative classification of primary disease, and the condition of patients penetrating keratoplasty or lamellar keratoplasty surgery. After long-term follow-up (3-24months) patients, visual acuity was observed in patients with surgery, the graft transparent case, the case of rejection, and to deal with other complications.Results1, Ceratonosus incidence by corneal transplantation in patients with a total of108cases (108eyes),65eyes of men, women,43eyes, minimum1years old, biggest65years old, the average age of47.5years. In the majority with patients between35to50years.2, this group of cases108eyes line as shown in the cornea transplant for the most common disease caused by various reasons of walleye, inflammatory and traumatic, congenital, etc.)36eyes, accounted for33.33%, followed by infectious keratitis25eyes (fungal corneal ulcer13eyes, bacterial corneal ulcer5eyes, viral keratitis (7eyes), accounting for23.15%.3, incidence eyesight improve93eyes after corneal transplantation, accounting for86.11%. Preoperative blind eyes of70eyes,55eyes after surgery, at a rate of78.57%.4, this group of85cases108eyes eyes planting in different degree of postoperative edema, elastic layer folds, after about1week after gradually faded, corneal graft transparency. Postoperative3months review, by reason of rejection or the loss of the corneal endothelium appeared different degree of corneal graft piece is cloudy and3months after transparent72eyes (66.67%), plant basic transparent25eyes (23.15%), plant opaque8eyes (7.41%), the total transparency rate94.12%.5, the incidence of postoperative patients with28eyes appear immune rejection, the rejection rate was25.93%.27eyes penetrating corneal transplantation immune rejection, rejection rate was31.76%. Lamellar corneal transplant rejection reaction probability is very small, only1case (4.35%), and the reaction degree of light.6,85eyes after penetrating keratoplasty in13cases (15.29%), high intraocular pressure, after through effects in drugs and stop using glucocorticoid therapy can effectively control, outpatient follow-up found no secondary glaucoma patients;1case (1.18%) of the plant of ulcer formation;3cases (3.53%), the primary disease recurrence.Incidence23eyes lamellar keratoplasty does not appear wear out planting bed, plant and plant bed involution difficulties, plant pills under the eyewinker residue, intraoperative complications such as eye wear out.2cases of postoperative patients with implant piece of new blood vessels,1case of recurrence of primary disease,2cases of plant and plant between fluid bed.Conclusion1, allogeneic corneal transplant is the treatment of complicated corneal lesions safe and effective surgical method.2, increase after penetrating corneal transplantation effect and rate is better than that of lamellar corneal transplantation.3, lamellar corneal transplantation immune rejection is far lower than the risk of penetrating corneal transplantation.4, occurring after allogeneic corneal transplantation immune rejection of the risk associated with preoperative primary disease and preoperative eye conditions.5, penetrating corneal transplant, the greater the diameter of donor graft piece, the greater the chances of rejection occurred after.6, the quality of the donor, surgical technique, postoperative complications of drug use and control is the success rate are key factors influencing the corneal transplant.