目的:报告应用交错分步进行的小切口非超声乳化白内障摘除、人工晶状体植入联合角膜移植(以下简称三联术)的方法治疗角膜病与白内障同时存在并需行穿透性角膜移植及白内障摘除复明的患者,并评价其疗效。方法:应用三联术对21例21眼角膜病合并白内障患者行手术治疗,观察术后视力、移植角膜情况,随访时间4～9mo。结果:治疗后92%患者术后裸眼视力比术前提高,术后2wk视力>0.5者9例(43%),>0.3者10例(48%),0.1者2例(10%)。术后7～14d,21眼角膜植片全为透明,术后4～9mo植片完全透明17例,植片呈半透明3例,角膜中度混浊伴新生血管长入1例。结论:穿透性角膜移植联合交错分步的小切口非超声乳化白内障摘除、人工晶状体植入术,可以一次性解决眼前段屈光间质混浊。与传统联合术相比,三联术减少了术后并发症,使患者快速恢复术后视力,安全性高。

AIM:To treat the patients with cararact and ceratonosus that need to be cured simultaneously with interlaced non-phacoemulsification cataract extraction,intraocular lens implantation and keratoplasty(triple procedure)and to observe and analyze the clinical effects of the triple procedure.METHODS:Twenty-one cases 21 eyes with cararact and ceratonosus were performed the triple procedure,and visual acuity,corneal grafts were observed. Follow-up period lasted for 4 months to 9 months postoperatively.RESULTS:The naked vision of 92% eyes were improved compared with that of the preoperative. In 9 cases (43%) visual acuity was over 0.5 after 2 weeks,and 10 cases (48%) over 0.3,2 cases (10%) were 0.1. All the corneal grafts were completely transparent 7 to 14 days after operation. Corneal grafts of 17 cases were completely transparent 4 to 9 months after operation,and corneal grafts of 3 cases were semitransparent. There was 1 case whose corneal graft was moderately turbid with neovessels.CONCLUSION:Interlaced non-phacoemulsification cataract extraction,keratoplasty and intraocular lens implantation can cure the patients’ refracting media turbidity of forepart eye and help them to get perception function at one time. Compared to the traditional thipe procedure,the interlaced tripe procedure can decrease trauma and post-operative complications with high safety.