Pluzsik Milán Tamás, Tóth Gábor, Tóth Jeannette, Matolcsy András, Langenbucher Achim, Kerényi Ágnes, Nagy Zoltán Zsolt, Szentmáry Nóra
Department of Ophthalmology, Semmelweis University, Budapest 1085, Hungary.
Department of Ophthalmology, Bajcsy-Zsilinszky Hospital, Budapest 1106, Hungary.
Int J Ophthalmol. 2020 Nov 18;13(11):1814-1819. doi: 10.18240/ijo.2020.11.20. eCollection 2020.
To analyze the changing trends in penetrating keratoplasty (PKP) indications.
This retrospective study included all patients with PKP between 2006 and 2017. Patients were classified using histological diagnoses. Our groups were as the following: pseudophakic or aphakic bullous keratopathy, regraft, acute necrotizing and ulcerative keratitis, keratoconus, Fuchs' dystrophy, corneal dystrophy other than Fuchs', corneal scar, other diagnoses and failed endothelial keratoplasty graft. Additionally, two different time-periods (2006-2012 and 2013-2017) were analysed.
Totally 1721 histological analyses of 1214 patients were available for review. The diagnoses were pseudophakic or aphakic bullous keratopathy in 487 (28.3%), regraft in 443 (25.7%), acute necrotizing and ulcerative keratitis in 313 (18.2%), corneal scar in 153 (8.9%), keratoconus in 140 (8.1%). Fuchs' dystrophy in 61 (3.5%), corneal dystrophy other than Fuchs' in 46 (2.7%), other diagnoses in 44 (2.6%) and failed endothelial keratoplasty graft in 34 (2.0%) cases. From the first to the second analysed time-period, incidence of acute necrotizing and ulcerative keratitis, corneal scar, Fuchs' dystrophy increased (≤0.032 for all) and incidence of keratoconus significantly decreased (=0.015).
Pseudophakic or aphakic bullous keratopathy is the leading indication for PKP, followed by regraft and acute necrotizing and ulcerative keratitis.
分析穿透性角膜移植术（PKP）适应证的变化趋势。
这项回顾性研究纳入了2006年至2017年间所有接受PKP的患者。根据组织学诊断对患者进行分类。我们的分组如下：人工晶状体眼或无晶状体眼大泡性角膜病变、再次移植、急性坏死性溃疡性角膜炎、圆锥角膜、富克斯角膜内皮营养不良、非富克斯角膜营养不良、角膜瘢痕、其他诊断以及内皮角膜移植失败。此外，还分析了两个不同的时间段（2006 - 2012年和2013 - 2017年）。
共对1214例患者的1721份组织学分析进行了回顾。诊断结果为：人工晶状体眼或无晶状体眼大泡性角膜病变487例（28.3%），再次移植443例（25.7%），急性坏死性溃疡性角膜炎313例（18.2%），角膜瘢痕153例（8.9%），圆锥角膜140例（8.1%），富克斯角膜内皮营养不良61例（3.5%），非富克斯角膜营养不良46例（2.7%），其他诊断44例（2.6%），内皮角膜移植失败34例（2.0%）。从第一个分析时间段到第二个时间段，急性坏死性溃疡性角膜炎、角膜瘢痕、富克斯角膜内皮营养不良的发生率增加（均≤0.032），圆锥角膜的发生率显著降低（=0.015）。
人工晶状体眼或无晶状体眼大泡性角膜病变是PKP的主要适应证，其次是再次移植和急性坏死性溃疡性角膜炎。
