Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Canada; and.
Johns Hopkins Wilmer Eye Institute, Odenton, MD.
Cornea. 2021 Nov 1;40(11):1420-1425. doi: 10.1097/ICO.0000000000002639.
To quantify practice patterns and assess attitudes and barriers to performing Descemet membrane endothelial keratoplasty (DMEK) in Canada.
An anonymous online survey was distributed to all corneal surgeons included in the Canadian Ophthalmological Society's database.
Of 70 listed surgeons, 41 responses were collected (58.6% response rate). Most respondents were practicing in university hospitals (43.9%) or private practice (43.9%) and were involved in residency teaching (77.5%). Most respondents performed DMEK surgery (78%), and most surgeons prepared their own DMEK grafts (62%). Surgeons who were in practice for more than 25 years were less likely to perform DMEK (75% vs. 13%, P = 0.009) and performed fewer corneal transplantation in the previous year (mean 28 vs. 44, P = 0.022). Those who were not performing DMEK reported access to preprepared tissue (77.8%), access to wet laboratory courses (50%), and assistance or mentorship (50%) as common facilitators to start performing DMEK surgery.
DMEK is the preferred surgery for endothelial disease among Canadian corneal surgeons. Eye banks play a key role in increased adoption by ensuring an adequate supply of tissue and prestripping tissue for surgeons new to DMEK to be confident in performing it. Ensuring adequate supply of donor tissue and supplementary surgeon training can ensure that DMEK surgery is widely available in Canada.
量化加拿大施行 Descemet 膜内皮角膜移植术（DMEK）的实践模式，并评估其态度和障碍。
向加拿大眼科学会数据库中列出的所有角膜外科医生分发匿名在线调查。
在列出的 70 名外科医生中，共收集到 41 份回复（58.6%的回复率）。大多数受访者在大学医院（43.9%）或私人诊所（43.9%）工作，并参与住院医师教学（77.5%）。大多数受访者施行 DMEK 手术（78%），并且大多数外科医生自己准备 DMEK 移植物（62%）。从业超过 25 年的外科医生施行 DMEK 的可能性较小（75%比 13%，P = 0.009），并且在前一年施行的角膜移植手术较少（平均 28 例比 44 例，P = 0.022）。那些未施行 DMEK 的医生报告称，获取预先准备好的组织（77.8%）、获取湿实验室课程（50%）以及获得协助或指导（50%）是开始施行 DMEK 手术的常见促进因素。
DMEK 是加拿大角膜外科医生治疗内皮疾病的首选手术。眼库通过确保组织的充足供应以及为新接触 DMEK 的外科医生预先剥离组织，在提高 DMEK 的采用率方面发挥着关键作用。确保供体组织的充足供应和补充外科医生培训可以确保 DMEK 手术在加拿大广泛应用。
