Muraine Marc, Sanchez Christian, Watt Laure, Retout Alain, Brasseur Gérard
Department of Ophthalmology, Hospital Charles Nicolle, Boulevard Gambetta, 76031 , Rouen cedex, France.
Graefes Arch Clin Exp Ophthalmol. 2003 Jul;241(7):571-576. doi: 10.1007/s00417-003-0691-z. Epub 2003 Jun 18.
The aim of this study was to retrospectively analyse the outcome of a series of grafted patients over a period of more than 10 years and to determine their long-term survival probability.
The records of 89 patients who had 103 grafts performed in 97 eyes were analysed. Mean follow-up was 12.8 years (range 10-17 years). Life table analysis (Kaplan-Meier) was used to evaluate the graft survival of the total population and of different groups.
Eighteen out of 89 patients (20.2%) had died. At the last visit before their death, 10 of the 21 grafts in those patients were still clear. Graft survival rates after 1, 2, 5 and 10 years were 79%, 73%, 59% and 50%; the rate at the end of follow-up was 47%. Survival rate at the end of the study was 94.7% for keratoconus, 57.1% herpes keratitis, 33.3% for pseudophakic keratopathies, 28.5% for post-traumatic keratopathies and 11.1% for re-grafts. In the group of patients grafted for aphakic or pseudophakic keratopathy, 40% died during the study. In 45% of cases their grafts were clear at the time of death. Endothelial decompensation and definitive graft rejection were the main causes of failure.
The outcome of keratoplasty is progressively getting worse with time in pseudophakic or traumatic keratopathies whereas survival rates are still stable from 10 to 17 years in grafts performed after keratoconus or herpetic keratitis.
本研究的目的是回顾性分析一系列超过10年的移植患者的结局，并确定其长期生存概率。
分析了89例患者97只眼行103次移植的记录。平均随访时间为12.8年（范围10 - 17年）。采用生命表分析（Kaplan - Meier）评估总体人群及不同组别的移植存活情况。
89例患者中有18例（20.2%）死亡。在这些患者死亡前的最后一次随访时，其21次移植中有10次仍保持透明。1年、2年、5年和10年后的移植存活率分别为79%、73%、59%和50%；随访结束时的存活率为47%。圆锥角膜患者在研究结束时的存活率为94.7%，疱疹性角膜炎患者为57.1%，人工晶状体眼性角膜病变患者为33.3%，创伤后角膜病变患者为28.5%，再次移植患者为11.1%。在因无晶状体或人工晶状体眼性角膜病变而接受移植的患者组中，40%在研究期间死亡。在45%的病例中，其移植在死亡时仍保持透明。内皮失代偿和确定性移植排斥是失败的主要原因。
人工晶状体眼性或创伤性角膜病变的角膜移植结局随时间推移逐渐变差，而圆锥角膜或疱疹性角膜炎后进行的移植在10至17年的存活率仍保持稳定。
