植床四点定位法降低深板层角膜移植后散光

背景：深板层角膜移植已广泛应用于圆锥角膜的治疗,不但能够达到与穿透性角膜移植术同样的增视效果,且具有移植后排斥反应发生率低等优点。目的：探讨采用植床四点定位法,降低深板层角膜移植后散光度的效果。方法：回顾性分析行深板层角膜移植的圆锥角膜病例50例(50眼),分别在移植中采用植床四点定位法25例(25眼)和直接剖切植床即未采用植床四点定位法25例(25眼),对比观察两组患者治疗后散光度及角膜地形图模拟角膜镜度数。结果与结论：移植后随访6-12个月,平均8.3个月。两组患者无角膜植片排斥反应、继发感染、继发性青光眼等发生。采用植床四点定位法,治疗后患者散光度及角膜地形图模拟角膜镜度数均较未采用四点定位降低。深板层角膜移植术中采用植床四点定位法能够有效地减少因眼内压下降、眼球变形、植床扭曲造成的移植后散光。 中国组织工程研究杂志出版内容重点：肾移植;肝移植;移植;心脏移植;组织移植;皮肤移植;皮瓣移植;血管移植;器官移植;组织工程全文链接：

Four-point fixation contributes to decreased astigmatism after deep lamellar keratoplasty

BACKGROUND: Deep lamellar keratoplasty has been widely used in the surgical treatment of keratoconus, which can increase the visual acuity similar to penetrating keratoplasty and has a low incidence of graft rejection. OBJECTIVE: To explore whether four-point fixation can effectively reduce postoperative astigmatism after deep lamellar keratoplasty. METHODS: A retrospective analysis was performed in 50 patients (50 eyes) with keratoconus who received deep lamellar keratoplasty. Intraoperative four-point fixation was performed in 25 cases (25 eyes) and direct cutting of the planting bed in another 25 cases (25 eyes). Postoperative astigmatism and simulated keratoscopy reading were compared between two groups. RESULTS AND CONCLUSION: All the patients were followed up for 6-12 months, an average of 8.3 months. There were no corneal graft rejections, infections, and secondary glaucoma in the two groups postoperatively. Postoperative astigmatism and simulated keratoscopy reading were better in patients undergoing the four-point fixation. These findings indicate that the four-point fixation technique is shown to effectively reduce postoperative astigmatism caused by eye deformation, bed distortion, and decreased intraocular pressure in deep lamellar keratoplasty.