目的探讨长期应用环孢素A(Cyclosporin A,CsA)联合地塞米松滴眼液对高危穿透性角膜移植术后免疫排斥反应的防治效果及其安全性..方法42例(42眼)高危穿透性角膜移植术后患者,术后3个月随机分为二组:Ⅰ组为实验组23例23眼,应用1%CsA和0.1%地塞米松溶液滴眼,每日各2～3次,交替用药,术后6个月后地塞米松浓度改为0.05%,每日各2次,交替用药,直至术后1年;Ⅱ组为对照组19例19眼在术后3月改为单纯1%CsA滴眼,每日3次,直至术后1年.所有病例随访观察1年以上.结果42眼PKP术后发生角膜植片免疫排斥反应11眼(26.19%),其中I组4眼(17.39%),Ⅱ组7眼(36.84%),差异具有显著性(P＜0.05).其它并发症的发生率两组间无显著性差异.术后患者视力均较术前明显提高,差异具有显著性(P＜0.05).结论较长期应用1%CsA联合地塞米松滴眼,可以安全、有效地降低高危PKP术后植片免疫排斥反应发生率,从而提高穿透性角膜移植的成功率.%Objective:To evaluate the efficacy and security of long - term topical use of 1% CsA combined with 0.1% dexmethasone (DXM) drops to prevent immunological rejection after high - risk penetrating keratoplasty(PKP). Methods :42 eyes of 42 cases with high - risk PKP were randomly divided into 2 groups 3 months after operations. Grou p l( experimental group): 23 eyes were treated with 1% CsA and DXM for 12 months. Group Ⅱ (control group): 19 eyes were treated with 1% CsA only for 12 months; All cases were followed up for 12 ～ 24 months. Results:There was a statistical difference between the two groups in postoperative immunological rejection that occurred in 7 out of 19 (36.84%) eyes in Group Ⅱ , and 4 out of 23 ( 17.39% ) in Group Ⅰ . There was no significant difference between the two groups in other postoperative complications. Conclusion :The result shows that long -term topical usc of CsA combined with DXM is more effective than that of CsA alone in decreasing the rejection rate with no significant increasing of the complications.
展开▼
