Galvis Virgilio, Tello Alejandro, Laiton Andrea N, Salcedo Stephany L L
Centro Oftalmológico Virgilio Galvis, Centro Medico Ardila Lulle, Torre A, Piso 3, Modulo 7, Floridablanca, Santander, Colombia.
Department of Ophthalmology, Fundación Oftalmológica de Santander FOSCAL, Floridablanca, Colombia.
Int Ophthalmol. 2019 Aug;39(8):1723-1733. doi: 10.1007/s10792-018-0994-z. Epub 2018 Jul 25.
To describe the indications and techniques of corneal grafting in a tertiary institution in a middle-sized city in Colombia.
A retrospective review of surgical reports and medical records of patients undergoing keratoplasty from January 2012 to December of 2016.
A total of 346 eyes from 316 patients were included. The first three indications for keratoplasty were: bullous keratopathy (BK) with 46.2% of the cases, active infectious keratitis (22.3%) and the group of corneal dystrophies and degenerations, including Fuchs' endothelial dystrophy (9%). Keratoconus was in the sixth place (4.9%). 73.3% of the procedures were penetrating keratoplasties (n = 255), 21.7% posterior lamellar (n = 75) and 3.5% anterior lamellar (n = 12). While in 2012, 25 cases of endothelial grafts were performed, only 13 were done in 2016.
BK was the first cause of keratoplasty with almost half of the cases, and keratoconus was relegated to sixth place with less than 5%. In comparison, in a study from eye banks from the US, BK was the second and keratoconus was the third indication for corneal grafts. The frequency of endothelial lamellar techniques in our institution decreased from 2012 to 2016. This could have been related to both the long time that the patients had to be on a waiting list, which made them unsuitable candidates for this technique, due to stromal fibrosis, and to the fact that surgeons of our institution had less experience with posterior endothelial grafting than with penetrating keratoplasties.
描述哥伦比亚一个中等城市的三级医疗机构中角膜移植的适应症和技术。
对2012年1月至2016年12月接受角膜移植手术患者的手术报告和病历进行回顾性研究。
共纳入316例患者的346只眼。角膜移植的前三个适应症为:大泡性角膜病变(BK),占病例的46.2%;活动性感染性角膜炎(22.3%);角膜营养不良和变性组,包括富克斯内皮营养不良(9%)。圆锥角膜排在第六位(4.9%)。73.3%的手术为穿透性角膜移植术(n = 255),21.7%为后板层角膜移植术(n = 75),3.5%为前板层角膜移植术(n = 12)。2012年进行了25例内皮移植,而2016年仅进行了13例。
BK是角膜移植的首要原因,几乎占病例的一半,圆锥角膜降至第六位,占比不到5%。相比之下,在美国眼库的一项研究中,BK是角膜移植的第二个适应症,圆锥角膜是第三个适应症。从2012年到2016年,我们机构内皮板层技术的频率有所下降。这可能既与患者在等待名单上的时间过长有关,由于基质纤维化,这使他们不适合这种技术,也与我们机构的外科医生在后板层内皮移植方面的经验不如穿透性角膜移植术丰富有关。