Palma-Carvajal F, Morales P, Salazar-Villegas A, Figueroa-Vercellino J P, Spencer F, Peraza-Nieves J, Sabater N, Torras J
Institut clínic d́oftalmología (ICOF), Hospital Clinic, Carrer de Sabino Arana, 1, 08028 Barcelona, Spain.
Cornea, Anterior Segment and Refractive Surgery Department, University of Ottawa Eye Institute, 501, Smyth Road, Ottawa, ON K1H 8M2, Canada.
J Fr Ophtalmol. 2020 Jan;43(1):1-6. doi: 10.1016/j.jfo.2019.06.026. Epub 2019 Dec 9.
To observe trends in surgical techniques for corneal transplantation and main indications in our hospital over the past five years.
Retrospective descriptive study, including all keratoplasties performed at the Hospital Clinic of Barcelona, Spain, between January 2014 and December 2018.
In total, 332 keratoplasties were performed. In total, 127 (38.25%) were penetrating keratoplasties (PK), and 205 (61.75%) were lamellar keratoplasties (LK). In 2014, a total of 48 keratoplasties were carried-out, whereas in 2018, the total was 93, which represents a 93.75% increase in corneal transplantation surgeries. Eye bank-delivered precut tissue for DMEK was introduced in 2016, and 3 cases (6.25%), were carried out that year. In 2018, DMEK became the leading technique with 56 cases (60.22%). Fuchs' dystrophy was the leading indication for corneal transplant (37.63%) in 2018.
Introduction of DMEK in a single center can be implemented in a relatively short period of time, becoming the most popular surgical procedure in corneal transplantation. A possible factor encouraging this change is the availability of eye bank-delivered precut tissue, and standardization of donor preparation and host surgical steps, optimizing surgical time in the operating room. This trend should lead to better visual outcomes, faster recovery times, and eventually to a higher surgical volume per year.
观察我院过去五年角膜移植手术技术的趋势及主要适应证。
回顾性描述性研究，纳入2014年1月至2018年12月在西班牙巴塞罗那医院诊所进行的所有角膜移植手术。
共进行了332例角膜移植手术。其中，穿透性角膜移植术（PK）127例（38.25%），板层角膜移植术（LK）205例（61.75%）。2014年共进行了48例角膜移植手术，而2018年这一数字为93例，角膜移植手术量增长了93.75%。2016年引入了眼库提供的预切割组织用于Descemet膜内皮角膜移植术（DMEK），当年进行了3例（6.25%）。2018年，DMEK成为主要技术，有56例（60.22%）。2018年，Fuchs角膜内皮营养不良是角膜移植的主要适应证（37.63%）。
在单一中心引入DMEK可在相对较短的时间内实现，成为角膜移植中最受欢迎的手术方式。促使这一变化的一个可能因素是眼库提供预切割组织的可用性，以及供体准备和受体手术步骤的标准化，优化了手术室的手术时间。这种趋势应能带来更好的视觉效果、更快的恢复时间，并最终实现每年更高的手术量。
