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印度北部一家三级护理中心穿透性角膜移植术的适应证与植片存活分析:一项为期5年的研究

Indications and graft survival analysis in optical penetrating keratoplasty in a tertiary care center in North India: a 5-year study.

作者信息

Arya Sudesh Kumar, Raj Amit, Bamotra Ravi Kant, Bhatti Anubha, Deswal Jyoti, Sindhu Meenakshi

机构信息

Department of Ophthalmology, D Block, Level 3, Government Medical College and Hospital, Sector 32, Chandigarh, 160030, India.

出版信息

Int Ophthalmol. 2018 Aug;38(4):1669-1679. doi: 10.1007/s10792-017-0641-0. Epub 2017 Jul 7.

Abstract

PURPOSE

To study the indications and variables correlating with graft survival in optical penetrating keratoplasty in a tertiary care hospital in north India.

PARTICIPANTS

All patients who underwent optical keratoplasty, except those undergoing lamellar grafts, tectonic grafts transplants and penetrating keratoplasty done for therapeutic purposes were included in the study. Patients with follow-up less than 2 years were excluded from the study.

MATERIALS AND METHODS

Data were obtained by reviewing the records of 101 patients who underwent optical penetrating keratoplasty from 2008 to 2013 for various indications.

RESULTS

Out of 101 patients who underwent optical penetrating keratoplasty, 71 were males and 30 were females. The mean age of the recipient was 48.53 years with range 1-82 years. The main indications were previous failed graft (29.7%), healed keratitis except HSV (15.8%), pseudophakic or aphakic bullous keratopathy (14.8%), corneal dystrophies/degenerations (12.9%), adherent leucoma (9.9%), post-HSV scars (8.9%), and others like anterior staphyloma, congenital corneal opacities, buphthalmos and keratoconus (7.9%). The graft survival rate was 67.33% at 1-year follow-up and 59.4% at 2-year follow-up. The mean survival time of the grafts was 22.42 months. The mean time for graft failure was 7.12 (±0.9) months.

CONCLUSION

One- and 2-year survival of grafts at our center is lower as compared to western studies, probably due to higher percentage of poor prognosis indications for surgery and a relative scarcity of excellent-quality donor corneas.

摘要

目的

在印度北部一家三级护理医院研究光学穿透性角膜移植术中与植片存活相关的指征和变量。

参与者

所有接受光学角膜移植术的患者,除了接受板层移植、结构性移植以及为治疗目的进行的穿透性角膜移植的患者均纳入本研究。随访时间少于2年的患者被排除在研究之外。

材料与方法

通过回顾2008年至2013年因各种指征接受光学穿透性角膜移植术的101例患者的记录来获取数据。

结果

在101例接受光学穿透性角膜移植术的患者中,男性71例,女性30例。受者的平均年龄为48.53岁,范围为1至82岁。主要指征为既往移植失败(29.7%)、除单纯疱疹病毒(HSV)外的愈合性角膜炎(15.8%)、人工晶状体眼或无晶状体眼大泡性角膜病变(14.8%)、角膜营养不良/变性(12.9%)、粘连性角膜白斑(9.9%)、HSV后瘢痕(8.9%)以及其他如前葡萄肿、先天性角膜混浊、牛眼和圆锥角膜(7.9%)。1年随访时植片存活率为67.33%,2年随访时为59.4%。植片的平均存活时间为22.42个月。植片失败的平均时间为7.12(±0.9)个月。

结论

与西方研究相比,我们中心1年和2年的植片存活率较低,可能是由于手术预后不良指征的比例较高以及优质供体角膜相对稀缺。

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