Department of Ophthalmology, Saarland University Medical Center, UKS , Homburg, Germany.
Department of Ophthalmology, Bajcsy-Zsilinszky Hospital , Budapest, Hungary.
Curr Eye Res. 2020 Oct;45(10):1199-1204. doi: 10.1080/02713683.2020.1737716. Epub 2020 Mar 13.
: To analyse the changing trends in penetrating keratoplasty indications between January 2011 and December 2018, at the Department of Ophthalmology, Saarland University Medical Center, Homburg/Saar, Germany. : This is a retrospective review of 2123 corneal buttons of 1776 patients (1993 eyes, 56.0% males, age at the time of surgery 57.6 ± 18.7 years), who underwent penetrating keratoplasty (PKP) between January 2011 and December 2018. The classification was performed based on histological analysis and using the priority scheme of Brady et al., supplemented by a group of "failed endothelial keratoplasty grafts". Our groups were the following: pseudophakic or aphakic bullous keratopathy, regraft, failed endothelial keratoplasty graft, acute necrotizing and ulcerative keratitis, keratoconus, Fuchs' dystrophy, corneal dystrophy other than Fuchs', corneal scars and other diagnoses. : Between 2011 and 2018, keratoconus was the leading indication for PKP in 455 (21.5%) cases, followed by acute necrotizing and ulcerative keratitis in 384 (18.1%), regraft in 367 (17.3%), corneal scars in 350 (16.5%), pseudophakic or aphakic bullous keratopathy in 225 (10.6%), Fuchs' dystrophy in 194 (9.1%), other diagnoses in 64 (3.0%), corneal dystrophy other than Fuchs' in 52 (2.4%), and failed endothelial keratoplasty graft in 32 (1.5%) cases. : With the introduction of posterior lamellar keratoplasty, keratoconus remains the leading PKP indication in our center with excimer laser-trephination on a routine basis. A trend towards increasing numbers can be observed regarding acute necrotizing and ulcerative keratitis patients and regrafts. However, the incidence of Fuchs' dystrophy decreased dramatically within PKP patients, with the introduction of posterior lamellar keratoplasty.
分析 2011 年 1 月至 2018 年 12 月德国萨尔兰大学医学中心洪堡眼科部门穿透性角膜移植术的适应证变化趋势。
本研究回顾性分析了 2011 年 1 月至 2018 年 12 月期间行穿透性角膜移植术的 1776 例（1993 只眼，男性占 56.0%，手术时的年龄为 57.6±18.7 岁）患者的 2123 个角膜瓣。根据组织学分析和 Brady 等人的优先方案进行分类，并补充了一组“失败的内皮角膜移植供体”。我们的分组如下：白内障或无晶状体眼大泡性角膜病变、再移植、失败的内皮角膜移植供体、急性坏死性和溃疡性角膜炎、圆锥角膜、Fuchs 营养不良、除 Fuchs 营养不良以外的角膜营养不良、角膜瘢痕和其他诊断。
2011 年至 2018 年间，圆锥角膜是穿透性角膜移植术的主要适应证，共 455 例（21.5%），其次是急性坏死性和溃疡性角膜炎 384 例（18.1%）、再移植 367 例（17.3%）、角膜瘢痕 350 例（16.5%）、白内障或无晶状体眼大泡性角膜病变 225 例（10.6%）、Fuchs 营养不良 194 例（9.1%）、其他诊断 64 例（3.0%）、除 Fuchs 营养不良以外的角膜营养不良 52 例（2.4%）、失败的内皮角膜移植供体 32 例（1.5%）。
随着后板层角膜移植术的开展，我院常规行准分子激光角膜磨镶术的圆锥角膜仍是穿透性角膜移植术的主要适应证。急性坏死性和溃疡性角膜炎患者及再移植患者的数量呈上升趋势。然而，随着后板层角膜移植术的开展，穿透性角膜移植术患者中 Fuchs 营养不良的发生率显著下降。
