目的： 研究异体角膜基质透镜植入联合角膜胶原交联手术治疗中晚期圆锥角膜的安全性及有效性。 方法 ：回顾性病例分析。选取在济南明水眼科医院角膜屈光科行同种异体角膜基质透镜植入联合角膜交联手术的中晚期圆锥角膜患者，术后随访至术后6个月的病例有19例（20眼），其中男15例（16眼），女4例（4眼），平均年龄（19.8±4.21）岁，分别在手术前及术后1周、1 个月、3个月、6个月进行眼科 常规及角膜生物力学各参数进行统计学分析，比较手术前后不同时间段的变化。 结果：角膜最薄点厚度、中央区上皮厚度、角膜膜平缓曲率（Kf）、陡峭曲率（Ks）、平均角膜曲率（Km）术前与术后各个时间段对比差异有统计学意义（P＜0.05）；最大压陷时间（HCT）、最大压陷反向曲率半径（HCR）、角膜第一次压平状态时的硬度参数(SP-A1)、综合半径指数(IR)、角膜中央点的厚度 (CCT)、角膜厚度变异率（ARTH）术后不同时间段与术前对比差异有统计学意义（P＜0.05）。 结论：异体角膜基质透镜植入联合角膜交联术能够有效增加角膜厚度，同时增加角膜硬度，术后角膜稳定性好，不易发生形变，角膜形态及生物力学稳定，显示出良好的安全性与稳定性。

Objective: To evaluate the safety and efficacy of allogeneic intrastromal lenticule implantation combined with corneal collagen cross-linking (CXL) in patients with moderate to advanced keratoconus. Method:A retrospective case series analysis was conducted. Nineteen patients (20 eyes) with moderate to advanced keratoconus who underwent combined allogeneic intrastromal lenticule implantation and CXL at the Corneal Refractive Department of Jinan Mingshui Eye Hospital were included and followed up for 6 months postoperatively. The cohort comprised 15 males (16 eyes) and 4 females (4 eyes), with a mean age of 19.8 ± 4.21 years. Comprehensive ophthalmic examinations and corneal biomechanical parameters were analyzed preoperatively and at 1 week, 1 month, 3 months, and 6 months postoperatively. Statistical analysis was performed to compare changes across these time points. Results: The thickness of the thinnest point of the cornea, the thickness of the central epithelium, the flat curvature of the corneal membrane (Kf), the steep curvature (Ks) and the mean corneal curvature (Km) were statistically significant between the preoperative and postoperative periods (P < 0.05). The maximum compression time (HCT), maximum compression radius of reverse curvature (HCR), hardness parameter (SP-A1), composite radius index (IR), corneal central point thickness (CCT) and corneal thickness variation rate (ARTH) were significantly different at different time periods after surgery compared with before surgery (P < 0.05). Conclusion: Combined allogeneic intrastromal lenticule implantation and CXL effectively increases corneal thickness and enhances corneal rigidity. Postoperatively, the cornea demonstrated favorable stability with reduced susceptibility to deformation. Both corneal topography and biomechanical properties were stabilized, indicating good safety and stability for treating moderate to advanced keratoconus.

2023年济南市卫生健康委员会大数据科技计划项目济南明水眼科医院院内项目（2025-1-01）；章丘区科技创新计划（社会民生发展、农业科技）项目（20242011）