周辺部角膜潰瘍に対する角膜移植

Tectonic keratoplasty for peripheral ulcerative keratitis

　モーレン角膜潰瘍11眼を含む周辺部角膜潰瘍14眼に対し治療的角膜移植を行った。手術回数は合計31回で1眼につき平均2.2回の移植を行った。術式は表層角膜移植（LKP）が27眼，LKP＋角膜上皮移植（KEP）が4眼であった。LKP 27眼のうち17眼は再移植を行った。LKP＋KEPを行った症例で再移植を行ったものはなかった。術後成績は12眼が結果良好であったが2眼は眼球摘出に至った。2眼の最終術式はLKPであった。

We performed tectonic keratoplasty in 14 eyes with peripheral ulcerative keratitis including 11 with Mooren's ulcer. A total of 31 surgeries were performed, average 2.2 for eye. Lamellar keratoplasty (LKP) was performed on 27 occasions and LKP combined with keratoepithelioplasty (KEP) on 4. Regraft-ing became necessary due to progressive corneal thinning in 17 of 27 eyes after LKP. The 4 eyes treated with LKP and KEP resulted in good outcome without necessitating regrafting. Final improvement in corneal ulceration was achieved in 12 of the 14 eyes. Clear corneal graft was obtained in 7 eyes. Two eyes had to be enucleated due to corneal melting, pain or blindness.