Wan Jifeng, Lin Jing, Hu Yin, Wei Menghuan, Zou Yingshi, Yuan Zhaohui
State Key Laboratory of Ophthalmology, Zhongshan Opthalmic Center, Sun Yat-Sen University, Guangzhou, China.
J Ophthalmol. 2020 Feb 11;2020:9041837. doi: 10.1155/2020/9041837. eCollection 2020.
To report the ratio of repeat-to-initial keratoplasty among patients who had underwent therapeutic keratoplasty for microbial keratitis in Southern China and to investigate the characteristics and risk factors of repeat keratoplasty.
A retrospective and inclusive review of the clinical records of patients who had received therapeutic keratoplasty for microbial keratitis, at Zhongshan Ophthalmic Center during December 2012 to January 2018, was performed. Patients who suffered coexistent endophthalmitis or underwent keratoplasty combined with other surgeries were excluded. Data on clinical characteristics of all eligible patients were collected.
A total of 447 patients were identified. Their mean age was 48.7 ± 15.5 years, and 290 (64.9%) were male. Out of the 447 patients, 18 (4.0%) received repeat keratoplasty. Their mean age was 45.9 ± 11.3 years, and 14 (77.8%) were male. The most common indication of repeat keratoplasty (12/18) was refractory infectious keratitis. Most of the patients (15/18, 83.3%) received the second keratoplasty within 12 months after the initial keratoplasty. Factors, including age, gender, initial causative organism, presence of initial corneal perforation, ocular comorbidities, and surgical procedures were not found statistically significantly different between patients who received and not received repeat keratoplasty.
The ratio of repeat-to-initial keratoplasty for therapeutic keratoplasty is low, compared to a failure rate of the initial grafts of over 50% reported in previous studies. The low ratio and the most common indication of repeat keratoplasty, refractory infectious keratitis, reflect caution for performing regrafts in such patients.
报告中国南方因微生物性角膜炎接受治疗性角膜移植术患者的再次角膜移植与初次角膜移植的比例，并调查再次角膜移植的特征和危险因素。
对2012年12月至2018年1月在中山眼科中心因微生物性角膜炎接受治疗性角膜移植术的患者临床记录进行回顾性全面分析。排除合并眼内炎或接受角膜移植联合其他手术的患者。收集所有符合条件患者的临床特征数据。
共纳入447例患者。他们的平均年龄为48.7±15.5岁，男性290例（64.9%）。在这447例患者中，18例（4.0%）接受了再次角膜移植。他们的平均年龄为45.9±11.3岁，男性14例（77.8%）。再次角膜移植最常见的指征（12/18）是难治性感染性角膜炎。大多数患者（15/18，83.3%）在初次角膜移植后12个月内接受了第二次角膜移植。在接受和未接受再次角膜移植的患者之间，年龄、性别、初次致病微生物、初次角膜穿孔的存在、眼部合并症和手术方式等因素在统计学上无显著差异。
与先前研究报道的初次移植失败率超过50%相比，治疗性角膜移植的再次角膜移植与初次角膜移植的比例较低。这一低比例以及再次角膜移植最常见的指征——难治性感染性角膜炎，反映了对此类患者进行再次移植时需谨慎。
