角膜交联术治疗晚期圆锥角膜的疗效观察和护理体会.docVIP

角膜交联术治疗晚期圆锥角膜的疗效观察和护理体会 1济南市中心医院济南250013； 2山东省立医院济南250021 摘要：目的：评价晚期圆锥角膜患者行核黄素诱导的长波紫外线角膜交 联术的安全性和有效性，探讨护理措施。方法：选择角膜厚度低于400mu;m的 圆锥角膜患者24人38眼，点低渗核黄素溶液使角膜基质水肿厚度达到 400mu;m以上，行角膜交联术。术前、术后记录观察最佳矫正视力、角膜顶点 K值、角膜厚度、角膜内皮、晶体等变化，对所有病人进行护理指导。结果：术 后所有患者角膜上皮于3?5天内愈合;角膜Haze于4周内消退;最佳矫正视力： 术前为 4.72plusmn;0.08,术后 3 月为4.80plusmn;0.05,6 月为4.91plusmn;0.04, 1 年为 4.93plusmn;0.06；角膜顶点 K 值：术前为 53.18plusmn;7.24D, 3 月为 52.47plusmn;5.62D, 6 月为 51.87plusmn;6.58D, 1 年为 51.69plusmn;6.3：LD； 角膜厚度治疗前为：367plusmn;33mu;m,水肿后为:412plusmn;65mu;m, 3 月为 373plusmn;37mu;m, 6 月为 350plusmn;351 年为 345plusmn;32mu;m；角膜内皮术前为：3072plusmn;203/mm2,术后 3 月为 2905plusmn;216/mm2, 6 月为 2969plusmn;218/mm2, 1 年为 2978plusmn;209/mm2；未见晶体、视网膜并发症。结论：采用低渗核黄素法行 角膜交联术治疗晚期角膜圆锥安全、有效，H当的护理可以消除紧张情绪，积极 配合治疗。 关键词：角膜交联，核黄素，紫外线，圆锥角膜 Clinical efficacy evaluation and nursing of riboflavin/UVA corneal crosslinking for late keratoc onus. [Abstract] Objective： This study was con ducted to evaluate the efficacy and safety of riboflavin/UVA corneal crosslinking in late keratoconus cases and to investigate nursing experienee. Methods： 38 eyes of 24 keratoconus patients with corneal thickness less than 400mu;m were recruited in the study. Hypo-osmotic riboflavin was applied until corneal thickness reached over 400mu;m? Then standard UVA/riboflavin corneal crosslinking was applied. BCVA, apex K value, corneal thickness, endothelium and lens changes were examined and recorded and proper n ursing was con ducted to all patients. Results： Cor neal epithelium was recovered within 3 to 5 days. Corneal haze was found in all patients and vanished within 4 weeks. BCVA was 4.72plusmn;0.08before treatment and 4.80plusmn;0.05, 4.92plusmn;0.04, 4.93plusmn;0.06three^ six and twelve months after. Apex K value was 56.29plusmn;7.33D before crosslinking and reached to 52.47plusmn;5.62D, 51.87plusmn;6.58D and 51.69plusmn;6.31Ddifferent intervals after treatment respectively. Corneal thickness was 367plusmn;33mu;m, 412plusmn;65mu;m, 373plusmn;37mu;m, 350plusmn;35mu;mand