University of Toronto Faculty of Medicine, ON, Canada.
Can J Ophthalmol. 2011 Aug;46(4):360-6. doi: 10.1016/j.jcjo.2011.06.015. Epub 2011 Jul 7.
To determine the changes in the leading indications for and the preferred surgical techniques of corneal transplantation in Ontario over a 9-year period.
Retrospective review of Eye Bank of Canada (Ontario Division) records.
Recipients of corneal transplants performed in Ontario between 2000 and 2009, totaling 6240 patients.
Records of all corneal tissues sent for transplantation in Ontario by the Eye Bank of Canada (Ontario Division) from July 1 2000 to June 30 2009 were reviewed. The records consist of recipient information forms completed by surgeons at the time of corneal transplant surgery. Of the 8186 available recipient information forms, 7755 (94.7%) were sufficiently complete to meet the inclusion criteria.
The leading indications for corneal transplantation were pseudophakic corneal edema (28.3%), regraft (21.5%), Fuchs dystrophy (16.6%), and anterior keratoconus (13.8%). Beginning in 2006, there has been a shift in the proportion of corneal transplants performed using Descemet's stripping automated endothelial keratoplasty (DSAEK) and deep anterior lamellar keratoplasty, from 2.4% to 36.1% of all corneal transplants. Concomitantly, DSAEK has replaced penetrating keratoplasty (PKP) as the technique of choice when corneal transplantation is indicated for Fuchs' dystrophy (139 DSAEKs vs. 68 PKPs in 2009) and for pseudophakic corneal edema (118 DSAEKs vs. 115 PKPs in 2009).
The indications for PKP in this study agree with the North American literature. In recent years, partial-thickness transplants have gained favor over PKP for select indications in Ontario. These changes reflect the future direction of corneal transplantation and will have implications on the supply of and demand for tissues.
在 9 年期间确定安大略省角膜移植的主要适应证和首选手术技术的变化。
回顾性审查加拿大眼库（安大略省分部）的记录。
2000 年至 2009 年间在安大略省接受角膜移植的患者，共 6240 例。
审查 2000 年 7 月 1 日至 2009 年 6 月 30 日期间加拿大眼库（安大略省分部）送往安大略省进行移植的所有角膜组织的眼库记录。记录包括手术时外科医生填写的受者信息表。在 8186 份可用的受者信息表中，有 7755 份（94.7%）足够完整，符合纳入标准。
角膜移植的主要适应证是白内障性角膜水肿（28.3%）、再移植（21.5%）、Fuchs 营养不良（16.6%）和前圆锥角膜（13.8%）。从 2006 年开始，使用 Descemet 撕囊自动化内皮角膜移植术（DSAEK）和深层前板层角膜移植术的角膜移植比例从所有角膜移植的 2.4%上升到 36.1%。同时，当 Fuchs 营养不良（2009 年 139 例 DSAEK 与 68 例 PKP）和白内障性角膜水肿（2009 年 118 例 DSAEK 与 115 例 PKP）需要角膜移植时，DSAEK 已取代穿透性角膜移植术（PKP）成为首选技术。
本研究中 PKP 的适应证与北美文献一致。近年来，在安大略省，对于某些特定适应证，部分厚度的移植术比 PKP 更受欢迎。这些变化反映了角膜移植的未来方向，并将对组织的供应和需求产生影响。
