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虹膜角膜内皮综合征穿透性角膜移植和内皮角膜移植术后移植物存活情况。

Graft Survival After Penetrating and Endothelial Keratoplasty in Iridocorneal Endothelial Syndrome.

机构信息

Moorfields Eye Hospital, London, United Kingdom; and.

Statistics and Clinical Studies, NHS Blood and Transplant, Bristol, United Kingdom.

出版信息

Cornea. 2020 Jan;39(1):18-22. doi: 10.1097/ICO.0000000000002039.

Abstract

PURPOSE

To compare the survival of a first penetrating keratoplasty (PK) or endothelial keratoplasty (EK) for iridocorneal endothelial (ICE) syndrome with transplant survival in Fuchs endothelial dystrophy (FED) and pseudophakic bullous keratopathy (PBK).

METHODS

We compared graft survival of PK and EK for ICE syndrome for 2 time periods. We then compared graft survival in ICE syndrome with graft survival in FED and PBK. Kaplan-Meier estimates of graft survival up to 5 years posttransplant were calculated with 95% confidence intervals (CI), whereas comparisons between the groups were performed using the log-rank test.

RESULTS

We included 86 first transplants for ICE syndrome. There was no difference in graft survival between the 58 PKs and the 28 EKs for up to 5 years after surgery (P = 0.717). For the period from 2009 to 2017, the 5-year graft survival rates for ICE syndrome were 64.3% (CI, 21.8%-88.0%) for the 16 PKs and 66.8% (CI, 41.8%-83.0%) for the 26 EKs (P = 0.469). Between 2009 and 2017, the 5-year survival rate for 42 grafts with ICE syndrome was 62.7% (CI, 39.6%-79.0%), which was lower than 75.9% (CI, 74.2%-77.4%) in 7058 transplants for FED but higher than 55.1% (CI, 52.0%-58.0%) in 3320 transplants for PBK, although the numbers of ICE transplants are too small to tell whether this difference was by chance.

CONCLUSIONS

The results indicate no difference in graft survival between PK and EK for ICE syndrome. Graft survival in ICE syndrome is intermediate between that of FED and PBK.

摘要

目的

比较虹膜角膜内皮(ICE)综合征的初次穿透性角膜移植(PK)或内皮角膜移植(EK)与 Fuchs 内皮营养不良(FED)和后发性白内障性大泡性角膜病变(PBK)的移植物存活率。

方法

我们比较了 ICE 综合征的 PK 和 EK 移植物存活率,分为两个时间段。然后,我们比较了 ICE 综合征与 FED 和 PBK 移植物存活率。通过计算 95%置信区间(CI),使用 Kaplan-Meier 估计值来评估移植后 5 年内的移植物存活率,而使用对数秩检验来比较组间差异。

结果

我们纳入了 86 例 ICE 综合征的初次移植。在手术后 5 年内,58 例 PK 和 28 例 EK 的移植物存活率无差异(P = 0.717)。对于 2009 年至 2017 年的时间段,ICE 综合征的 5 年移植物存活率为 16 例 PK 的 64.3%(CI,21.8%-88.0%)和 26 例 EK 的 66.8%(CI,41.8%-83.0%)(P = 0.469)。在 2009 年至 2017 年期间,42 例 ICE 综合征的移植物 5 年存活率为 62.7%(CI,39.6%-79.0%),低于 7058 例 FED 移植的 75.9%(CI,74.2%-77.4%),但高于 3320 例 PBK 移植的 55.1%(CI,52.0%-58.0%),尽管 ICE 移植的数量太少,无法确定这种差异是否偶然。

结论

结果表明 ICE 综合征的 PK 和 EK 之间的移植物存活率无差异。ICE 综合征的移植物存活率在 FED 和 PBK 之间。

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