Department of Ophthalmology, University of Tokyo School of Medicine, Tokyo, Japan.
Cornea. 2010 May;29(5):528-30. doi: 10.1097/ICO.0b013e3181c29705.
To investigate the extended long-term results of penetrating keratoplasty (PK) for keratoconus.
The subjects were all patients with clinical keratoconus who underwent initial PK at University of Tokyo from 1971 to 1990 and whose medical records were available. Data were retrieved from the medical records. Kaplan-Meier survival analysis was performed to estimate the cumulative probability of immune reaction-free grafts and graft survival.
One hundred twenty-five eyes in 125 patients met the entry criteria. The average age at the time of PK was 25.0 +/- 8.9 years. With an average follow-up period of 15.3 +/- 9.7 years, 12 eyes (9.6%) experienced rejection and 5 eyes (4.0%) experienced graft failure. Average best-corrected visual acuity in logarithm of the minimum angle of resolution at preoperation, 10, 20, and 25 years after surgery was 1.54 +/- 0.68, 0.06 +/- 0.22, 0.03 +/- 0.17, and 0.14 +/- 0.42, respectively. The cumulative probability of graft survival at 10, 20, and 25 years after PK was 98.8%, 97.0%, and 93.2%, respectively.
Recovery of visual acuity was good after PK for keratoconus in an extended follow-up. The graft survival rate, however, gradually decreased 20 years after PK.
研究穿透性角膜移植术（PK）治疗圆锥角膜的长期扩展结果。
本研究对象均为 1971 年至 1990 年期间在东京大学接受初次 PK 的临床诊断为圆锥角膜的患者，且其病历资料完整。从病历中提取数据。采用 Kaplan-Meier 生存分析估计无免疫反应性移植物和移植物存活率的累积概率。
符合纳入标准的共有 125 只眼 125 例患者。PK 时的平均年龄为 25.0±8.9 岁。平均随访 15.3±9.7 年后，有 12 只眼（9.6%）发生排斥反应，5 只眼（4.0%）发生移植物失败。术前、术后 10、20、25 年最佳矫正视力的对数最小角分辨率平均值分别为 1.54±0.68、0.06±0.22、0.03±0.17、0.14±0.42。PK 后 10、20、25 年移植物存活率的累积概率分别为 98.8%、97.0%和 93.2%。
在长期随访中，PK 治疗圆锥角膜后视力恢复良好。然而，移植物存活率在 PK 后 20 年逐渐下降。
