[德国角膜病理学现状：德国眼科学会（DOG）角膜分会成员调查结果]

Rohrbach Jens Martin, Seitz Berthold, Holbach Leonard M

Augenklinik des Universitätsklinikums, Abt. I, Tübingen.

Klin Monbl Augenheilkd. 2003 Oct;220(10):682-8. doi: 10.1055/s-2003-43133.

BACKGROUND

The current situation of corneal pathology is widely unknown. Especially, there are no data available how corneal tissue is processed after penetrating keratoplasty.

MATERIAL AND METHODS

In November 2002 a questionnaire with 15 questions was sent to all registered members of the cornea section of the German Ophthalmological Society (DOG) ( www.sektionkornea.org ) via email. Only one answer per eye clinic was allowed.

RESULTS

Answers were obtained from 40 eye hospitals in which 3070 penetrating keratoplasties had been performed in 2001. 90 % of the surgeons believe that ophthalmopathological investigations of excised corneal specimens are always or at least in some cases important, and 80 % examine 75 to 100 % of all corneal buttons. However, the corneoscleral rim is investigated only exceptionally. 45 % of all corneal buttons are examined by a pathologist within the hospital while 33 % of the corneal specimens are investigated by an ophthalmopathologist in an ophthalmopathological laboratory. In most cases the hospital itself has to bear the cost. Clinics with a high number of corneal transplantations do not differ from the average regarding the fate of corneal buttons. Morphological investigations and publications concerning the cornea are more frequent when an ophthalmopathological laboratory is available in the hospital.

CONCLUSIONS

For most eye hospitals performing keratoplasties, the histopathological examination of excised corneal buttons is very important. It is carried out to a large extent by pathologists, but specialised ophthalmopathological laboratories are consulted when a profound expertise is needed. Thus, this survey is an argument for the preservation of these laboratories too. Based on the obtained data and on several comments by the section members initiatives to intensify histopathological investigations of excised corneal specimens should be undertaken.

背景

角膜病理学的现状广为人知。特别是，关于穿透性角膜移植术后角膜组织如何处理尚无可用数据。

材料与方法

2002年11月，通过电子邮件向德国眼科学会（DOG）角膜分会（www.sektionkornea.org）的所有注册会员发送了一份包含15个问题的问卷。每家眼科诊所仅允许给出一个答案。

结果

从40家眼科医院获得了答案，这些医院在2001年共进行了3070例穿透性角膜移植手术。90%的外科医生认为对切除的角膜标本进行眼科病理检查总是或至少在某些情况下很重要，80%的医生检查了所有角膜植片的75%至100%。然而，角巩膜缘仅偶尔进行检查。45%的角膜植片由医院病理学家检查，而33%的角膜标本由眼科病理实验室的眼科病理学家检查。在大多数情况下，费用由医院自行承担。角膜移植手术数量较多的诊所与角膜植片的处理情况平均水平并无差异。当医院设有眼科病理实验室时，关于角膜的形态学研究和出版物更为频繁。

结论

对于大多数进行角膜移植手术的眼科医院而言，对切除的角膜植片进行组织病理学检查非常重要。这项工作在很大程度上由病理学家完成，但在需要专业知识时会咨询专门的眼科病理实验室。因此，这项调查也为保留这些实验室提供了依据。基于所获得的数据以及分会成员的一些意见，应采取措施加强对切除的角膜标本的组织病理学研究。