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目的探讨深板层角膜内皮移植术(deeplamellarendothelialkeratoplasty,DLEK)治疗角膜内皮性病变的临床疗效。方法对5例6眼因角膜内皮病变导致角膜水肿或大泡性角膜病变眼行深板层角膜内皮移植术。1眼供、受体角膜和植片均用微型角膜刀制备,另5眼供体深板层内皮植片用微型角膜刀制作,受体带蒂角膜瓣以虹膜恢复器分离制作;其中1例2眼为先天性角膜内皮营养不良,4例4眼为白内障术后大泡性角膜病变。结果4眼随访12个月以上,2眼随访4个月。所有病例角膜持续透明,术后视力均有明显提高,患者术后1个月平均角膜内皮细胞密度为2189/mm2(1594～2641),角膜厚度平均为568μm(510～675)。结论与传统的PKP比较,DLEK具有术后视力恢复快、角膜高度散光机率小、排斥反应风险小等优点,是一种治疗角膜内皮性病变的有效方法。
Objective To investigate the clinical effect of deep lamellar keratoplasty (DLEK) on corneal endothelial lesions. Methods In 5 cases of 6 eyes due to corneal endothelial lesions lead to corneal edema or bullous keratopathy underwent deep lamellar keratoplasty. 1 for the cornea, the recipient cornea and the graft were prepared with a microkeratome, the other five donor plate deep layer of endothelial implants made with a microkeratome, the recipient pedicle flap was isolated with iris recovery device; one case 2 eyes of congenital corneal endothelial malnutrition, 4 cases of 4 eyes after cataract surgery bullous keratopathy. Results 4 eyes were followed up for more than 12 months, 2 eyes were followed up for 4 months. In all cases, the cornea continued to be transparent and the postoperative visual acuity was significantly improved. The mean corneal endothelial cell density was 2189 / mm2 (1594 ~ 2641) and the mean corneal thickness was 568μm (510 ~ 675) at 1 month after operation. Conclusion Compared with the traditional PKP, DLEK has the advantages of rapid recovery of visual acuity, low rate of corneal astigmatism and low risk of rejection. It is an effective method for the treatment of corneal endothelial lesions.