| 摘要
目的：分析圆锥角膜（KC）手术前后角膜规则程度的变化, 对穿透性角膜移植手术（PK）在KC治疗中的意义进行评价。
病例和方法：回顾分析了236例使用激光环钻和16针双线连续缝合的圆锥角膜手术，使用角膜曲率计(Ophthalmometer, Type-H, 190071 Zeiss, Jena, Germany)对手术前后的角膜规则程度进行检测, 并结合所测出的角膜曲率(K)值和角膜映光图形分组：（1）规则组，K<50D；（2）轻度不规则组，K<60；（3）中度不规则组，K>60；（4）重度不规则组，K值不能读出，共4组。手术后12个月、18个月分别拆除连续缝线，并同时随访记录各组别角膜规则程度，分析以上三个时间点角膜规则程度的动态变化趋势。
结果：在三个时间点，规则组比例的递增趋势为4%—37%—61%；轻度不规则组的变化趋势为12%—51%—33%；中度不规则组的变化趋势为38%—10%—4%；重度不规则组的变化趋势为46%—2%—2%。
结论：使用激光环钻和16针双线连续缝合的圆锥角膜手术病例中，穿透性角膜移植手术能有效改善病人的角膜表面规则程度，缝线拆除并不能导致术后角膜规则程度下降。
关键词：圆锥角膜，穿透性角膜移植手术，角膜规则程度，缝线拆除。
Abstract
Purpose: To analyze the corneal regularity of pre- and post-surgery in keratocunus and the effect of suture removal on corneal regularity.
Patients and Metholds: 236 patients were performed penetrating keratoplasty, in which laser trephination and 16 bites double-running suturing techniques were applied. Patients were assigned to four groups: （1）K<50D，regular mire; (2) K<60, mildly irregular mire; (3) K>60, moderately irregular mire; (4) severe irregular, immeasurable mire based on the keratometry value and mires measured with semi-quantitative Ophthalmometer(Type-H, 190071 Zeiss, Jena, Germany). The first and second suture was removed 12 and 18 months after surgery, while corneal regularity measurements were followed up and evaluated
Results: Upon the time point of measured, the proportion of each group showed alternative tendency as: group (1), 4%—37%—61%; group (2), 12%—51%—33%; group (3), 38%—10%—4%; group (4), 46%—2%—2%.
Conclusions: Penetrating keratoplasty with laser trephination and 16 bites double-running suturing techniques can improve the corneal regularity of keratoconus, suture removal can not lead to an increase of corneal irregularity.
Key Words: keratoconus, penetrating keratoplasty, corneal regularity, suture removal
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