Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ont.
Can J Ophthalmol. 2013 Jun;48(3):153-9. doi: 10.1016/j.jcjo.2012.12.008.
To evaluate trends in indications for and preferred surgical techniques of corneal transplantation in Ontario over a 12-year period.
Retrospective review of recipient information forms collected by Eye Bank of Canada (Ontario Division).
Patients who received corneal transplantation in Ontario between 2000 and 2012, totaling 11,725 corneal transplants performed.
Database containing information collected from recipient information forms maintained by the Eye Bank of Canada (Ontario Division) was reviewed. Corneal transplants performed between July 1, 2000, and June 30, 2012, in Ontario were analyzed. Surgeons complete recipient information forms at the time of corneal transplant surgery. Of the 11,725 available recipient information forms, 10,906 (93%) were sufficiently complete to meet the inclusion criteria and were included in the study.
Since 2009, Fuchs endothelial dystrophy overtook pseudophakic corneal edema as the leading indication for corneal transplantation. Since the shift toward lamellar keratoplasty in 2006, there has been a significant decrease in number of corneal transplants performed with penetrating keratoplasty (PKP; p = 0.0016) and a significant increase in Descemet stripping automated endothelial keratoplasty (DSAEK; p = 0.0069) and deep anterior lamellar keratoplasty (p = 0.0108). The gap between number of PKPs and DSAEKs performed each year is progressively narrowing. From July 1, 2011, to June 30, 2012, 514 PKPs were performed compared with 420 DSAEKs. From 2011 to 2012, 83% of corneal transplants indicated by Fuchs endothelial dystrophy were performed with DSAEK, whereas only 13% were performed with PKP.
Six years since initial implementation, partial thickness transplantation continues to increase in popularity. Corneal tissue supply and demand will need to reflect these changes in the field of corneal transplantation.
评估在 12 年期间安大略省角膜移植适应证和首选手术技术的趋势。
回顾加拿大眼库（安大略分部）收集的受者信息表。
2000 年至 2012 年间在安大略省接受角膜移植的患者，共进行了 11725 例角膜移植。
对加拿大眼库（安大略分部）保存的受者信息表中收集的信息进行了回顾。分析了 2000 年 7 月 1 日至 2012 年 6 月 30 日在安大略省进行的角膜移植。外科医生在进行角膜移植手术时填写受者信息表。在 11725 份可用的受者信息表中，有 10906 份（93%）足够完整，符合纳入标准，并纳入研究。
自 2009 年以来，Fuchs 内皮营养不良超过白内障性角膜水肿，成为角膜移植的主要适应证。自 2006 年转向板层角膜移植以来，穿透性角膜移植术（PKP）的角膜移植数量显著减少（p=0.0016），而 Descemet 撕囊自动角膜内皮移植术（DSAEK）和深层前板层角膜移植术（p=0.0108）显著增加。每年 PKP 和 DSAEK 手术数量之间的差距正在逐渐缩小。从 2011 年 7 月 1 日至 2012 年 6 月 30 日，共进行了 514 例 PKP，420 例 DSAEK。从 2011 年到 2012 年，Fuchs 内皮营养不良的 68%角膜移植采用 DSAEK 进行，而仅 13%采用 PKP 进行。
在初步实施后的 6 年里，半厚度移植术的应用持续增加。角膜组织的供需情况需要反映角膜移植领域的这些变化。
