Department of Ophthalology, Lister Centre, Manchester Royal Eye Hospital, Manchester, UK.
Eye (Lond). 2009 Jun;23(6):1288-94. doi: 10.1038/eye.2008.305. Epub 2008 Oct 24.
Corneal transplantation is the most common form of transplantation with approximately 2500 grafts undertaken annually in the United Kingdom. The modern day success of transplantation is attributed to eye bank storage techniques, ocular pharmacology, and improved surgical techniques.
This retrospective case note review identified 203 penetrating keratoplasties (PKs) performed during a period from 1 January 2000 to 31 December 2003 at Manchester Royal Eye Hospital. Preoperative risk factors, surgical technique, postoperative complications, and Snellen acuity were analysed.
The mean age of the recipient group was 56.7 years, with 107 right eyes and 96 left eyes. The mean follow-up was 61 months. The overall 5-year survival was 82%, with keratoconus and corneal dystrophies at 93 and 89%, respectively. Visual acuity had improved to 6/12 or better in 48% of patients postoperatively, compared with 8% preoperatively. Forty-three donor grafts (21%) underwent at least a single episode of endothelial rejection. Glaucoma was a finding in 37 (18%) of patients following PK. In all, 16 grafts of 15 patients were noted to have suffered microbial keratitis (MK), an incidence of 8%.
PK is currently an effective long-term treatment option for improving visual function. An overall survival rate of 82% over 5 years is comparable with other published studies and is largely dependent on recipient factors. This report emphasises the significant complications of immunological rejection, glaucoma, and microbial keratitis, which continue to limit success.
角膜移植是最常见的移植形式，在英国每年大约进行 2500 例移植。现代移植的成功归因于眼库储存技术、眼部药理学和改进的手术技术。
本回顾性病例记录研究确定了 203 例穿透性角膜移植术（PK），这些手术是在 2000 年 1 月 1 日至 2003 年 12 月 31 日期间在曼彻斯特皇家眼科医院进行的。分析了术前危险因素、手术技术、术后并发症和 Snellen 视力。
受者组的平均年龄为 56.7 岁，右眼 107 例，左眼 96 例。平均随访时间为 61 个月。整体 5 年生存率为 82%，其中圆锥角膜和角膜营养不良分别为 93%和 89%。术后有 48%的患者视力提高到 6/12 或更好，而术前为 8%。43 个供体移植物（21%）至少经历了一次内皮排斥反应。PK 后有 37 例（18%）患者出现青光眼。共有 16 例（15 例患者）的移植物被发现患有微生物角膜炎（MK），发病率为 8%。
PK 目前是改善视力功能的一种有效长期治疗选择。5 年内总体存活率为 82%，与其他已发表的研究相似，主要取决于受者因素。本报告强调了免疫排斥、青光眼和微生物角膜炎等重大并发症，这些并发症仍然限制了手术的成功率。
