摘要目的 观察颞下方巩膜垂直切口穿刺放液在深板层角膜移植术中前房维持情况、对基质层注气的影响及对角膜内皮细胞的保护作用.方法 总结圆锥角膜患者20例(20只眼)行深板层角膜移植术.将20例病例分为两组(Ⅰ组10例,Ⅱ组10例),Ⅰ组病人术中行颞下方角膜缘内穿刺放液,Ⅱ组病人术中行颞下方巩膜垂直切口穿刺放液,术中观察前房维持情况及注气过程中气泡进入前房情况,术后观察植片水肿情况.结果Ⅰ组病人中:9例周边前房消失时间超过30 min,在逐层注气过程中8例气泡通过角膜缘内穿刺放液孔进人前房,术中眼压升高,术后全部出现程度不同的植片水肿,2例出现层间积液.Ⅱ组病人中,术中周边前房消失时间全部小于15 min,在逐层注气过程中无l例气泡自巩膜穿刺放液孔进入前房,术后4例植片无水肿,6例轻度水肿.结论 颞下方巩膜垂直切口穿刺放液在深板层角膜移植术中不仅可以有效地降低眼内压,且可以更好地保护角膜内皮细胞,为手术成功提供保障.

abstractsObjective To observe the vertical temporal scleral incision below the paracentesis in deep larnellar keratoplasty in the anterior chamber to maintain the situation on the substrate layer gas injection and effects on corneal endothelial cells in rats.Methods Summary of 20 patients with keratoconus (20 eyes) underwent deep lamellar keratoplasty.The 20 cases were divided into two groups (group Ⅰ of 10 eases,group l of 10 patients),group Ⅰ under intraoperative temporal limbal paracentesis within,group Ⅱ under intraoperative temporal seleral incision paracentesis vertical,the situation in the anterior chamber operation,maintenance of air bubbles during gas injection into the anterior chamber and the graft edema after surgery were observed.Results Group Ⅰ patients:peripheral anterior chamber disappeared more than 30 minutes in 9 cases,the bubble through the limbus into the anterior chamber paracentesis hole during gas injection into layer in 8 cases with intraoperative intraocular pressure,all cases had different levels of graft edema after surgery,fluid into layers in 2 cases.Group Ⅱ patients:the anterior chamber disappearance time of all cases was less than 15 minutes,none of the cases had the bubble holes from the sclera into the anterior chamber paracentesis during gas injection into layer by layer,4 cases of the graft had no edema after surgery,however 6 cases had edema.Conclusions The bottom of the vertical temporal scleral incision paracentesis in deep lamellar keratoplasty can reduce intraocular pressure effectively and protect the corneal endothelial cells better.It provides successful operation protection.