Bigan Guillaume, Puyraveau Marc, Saleh Maher, Gain Philippe, Martinache Isabelle, Delbosc Bernard, Gauthier Anne-Sophie
1 Department of Ophthalmology, University Hospital of Besançon, Besançon, France.
2 Clinical Trials Statistical, Faculty of Medicine, University of Franche-Comté, Besançon, France.
Eur J Ophthalmol. 2018 Sep;28(5):535-540. doi: 10.1177/1120672118762224. Epub 2018 Apr 12.
The aim of this study was to report the 12-year longitudinal trends in indication and corneal transplantation techniques in France from 2004 to 2015.
The records of all corneal transplantations performed from 2004 to 2015 in France were retrospectively reviewed. The patient indications and types of transplant performed were analyzed. A total of 46,658 corneal transplantations were performed between 2004 and 2015, with 34,187 (73.3%) penetrating keratoplasty and 10,452 (22.4%) lamellar keratoplasty. The leading surgical indications were secondary endothelial failure (24.3%), keratoconus (18.8%), regraft (13.5%), and Fuchs endothelial corneal dystrophy (15.1%). Endothelial keratoplasty became the preferred technique for endothelial diseases and deep anterior lamellar keratoplasty the preferred technique for keratoconus, surpassing penetrating keratoplasty in 2013.
Secondary endothelial failure is the top indication for performing a keratoplasty over the 12-year period. There was a shift from penetrating keratoplasty to endothelial keratoplasty performed for Fuchs endothelial corneal dystrophy and secondary endothelial failure, and to deep anterior lamellar keratoplasty, performed for keratoconus. This highlights an important shift in managing corneal diseases toward the application of selective and more conservative surgeries and changes in indications in corneal transplantation.
本研究旨在报告2004年至2015年法国角膜移植适应症和技术的12年纵向趋势。
对2004年至2015年在法国进行的所有角膜移植记录进行回顾性分析。分析了患者的适应症和移植类型。2004年至2015年共进行了46658例角膜移植，其中穿透性角膜移植34187例（73.3%），板层角膜移植10452例（22.4%）。主要手术适应症为继发性内皮功能衰竭（24.3%）、圆锥角膜（18.8%）、再次移植（13.5%）和富克斯内皮角膜营养不良（15.1%）。内皮角膜移植术成为治疗内皮疾病的首选技术，而深前板层角膜移植术成为治疗圆锥角膜的首选技术，在2013年超过了穿透性角膜移植术。
继发性内皮功能衰竭是12年间进行角膜移植的首要适应症。对于富克斯内皮角膜营养不良和继发性内皮功能衰竭，角膜移植术从穿透性角膜移植术转向内皮角膜移植术，对于圆锥角膜，则转向深前板层角膜移植术。这突出了角膜疾病管理向应用选择性和更保守手术的重要转变以及角膜移植适应症的变化。
