摘要目的 探讨穿透性角膜移植术(PKP)后白内障摘除术的临床疗效.方法 回顾性分析2004年1月至2007年7月行白内障摘除术的穿透性角膜移植术后患者16例,根据晶状体核硬度分级,分别采取白内障超声乳化摘除联合人工晶状体植入术(phaco+pcIOL)和白内障囊外摘除联合人工晶状体植入术(ECCE+pcIOL),统计患者手术前后视力,角膜水肿及角膜内皮细胞(CEC)情况的变化.结果 术后3个月最佳矫正视力:0.2～0.5,均较术前提高.经治疗术后角膜水肿均于1周内消除,术后角膜内皮细胞密度均较术前减少,但术后内皮细胞丢失率phaco+PCIOL组((9.1±2.3)%)较ECCE+PCIOL组((8.3±2.6)%)差异无统计学意义(P>0.05),经术后5～30个月的随访,角膜移植片均保持透明,无一例大泡性角膜病变发生.结论 对穿透性角膜移植术后的白内障患者,综合评价术前情况选择适当的手术方式,白内障摘除联合人工晶状体植入术疗效确实,可获得满意的手术结果.

abstractsObjective To study the effect of cataract extraction and intraocular lens implantation after penetrating keratoplasty (PKP) and to evaluate the clinical results.Methods Of 16 patients who received cataract surgery after PKP between January 1,2004 and July 31,2007 were reviewed retrospectively.According to hardness of cataract, phacoemulsification or planned extracapsular cataract extraction were performed with intraocular lens implantation.Visual acuity, corneal endothelial cell (CEC) density before and after cataract surgery were recorded, and the transparence of the transplanted corneas were observed.Results The best cor-rected visual acuity was ranged from 0.2-0.5 three month after operation.The transplanted corneas showed low-er CEC densities in all patients.The CEC loss rate in patients performed with phaco was 9.1%, which was the same as the patients performed with ECCE of 8.3% (P>0.05).All transplanted corneas remained transparent in the following-up time of 5-30 months and bullous keratopathy were not observed.Conclusions To choose the best way of operation on those post keratoplasty cataract patients, pre-operative considerations should be as-sessed comprehensively, and the satisfied clinical results can be obtained.