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2001-2020 年波兰南部某中心进行的角膜移植的适应证和技术。

Indications and techniques of corneal transplants performed in one center in Southern Poland, in the years 2001-2020.

机构信息

Chair and Clinical Department of Ophthalmology Faculty of Medical Sciences in Zabrze Medical University of Silesia in Katowice, Katowice, Poland.

Department of Ophthalmology, District Railway Hospital in Katowice, Katowice, Poland.

出版信息

PLoS One. 2022 Nov 18;17(11):e0276084. doi: 10.1371/journal.pone.0276084. eCollection 2022.

Abstract

PURPOSE

The study aimed to evaluate changes over a period of time in techniques and indications for corneal transplantation in a single center in Poland.

METHODS

Retrospective analysis of corneal transplants performed at the Ophthalmology Department of the District Railway Hospital in Katowice in 2001-2020. Data on indications and surgical technique were collected.

RESULTS

A total of 3021 corneal transplantations were performed in the years 2000-2020. The most common technique was penetrating keratoplasty (69,54%), then lamellar grafts-both anterior and posterior (19,63%), and limbal grafts (10,82%). Only in 2007 the number of lamellar keratoplasties exceeded the number of penetrating grafts and accounted for 108 (54,55%), including 85 (42,93%) of Descemet Stripping Automated Endothelial Keratoplasty. The only noticeable trend in changing techniques was a decrease in the number of performed deep anterior lamellar keratoplasties (r 2 = -0.21) over the last seven years. Main indications included bullous keratopathy (23,22%), following keratoconus (18,59%), leukoma (14,67%), keratitis and perforation (14,3%), Fuchs dystrophy (11,4%), and regrafts (7,22%). Leukoma and bullous keratopathy as an indications for corneal transplant have been declining over the years (r2 = 0.60 and r2 = 0.30 respectively). Consecutively, indications such as fuchs dystrophy, regraft and keratitis perforation have increased (r2 = 0.05, r2 = 0.50, r2 = 0.33).

CONCLUSIONS

The number of keratoplasties gradually increased from 2001 to 2020. It could be possible that the development and spread of new therapeutic alternatives, like corneal cross-linking and scleral lenses, have contributed to the decrease in deep anterior lamellar keratoplasty performed. There was an increasing trend in the percentage of penetrating keratoplasties for failed grafts, Fuchs dystrophy and infectious keratitis.

摘要

目的

本研究旨在评估波兰某单一中心角膜移植技术和适应证随时间的变化。

方法

对 2001 年至 2020 年期间在卡托维兹地区铁路医院眼科进行的角膜移植进行回顾性分析。收集适应证和手术技术数据。

结果

2000 年至 2020 年共进行了 3021 例角膜移植。最常见的技术是穿透性角膜移植术(69.54%),其次是板层移植物(包括前板层和后板层)(19.63%)和缘基质移植术(10.82%)。仅在 2007 年,板层角膜移植的数量超过穿透性移植术,占 108 例(54.55%),其中 85 例(42.93%)为去表皮撕除式自动角膜内皮移植术。过去七年来,技术上唯一明显的变化趋势是深层前板层角膜移植术的数量减少(r2 = -0.21)。主要适应证包括大泡性角膜病变(23.22%)、圆锥角膜(18.59%)、角膜白斑(14.67%)、角膜炎和穿孔(14.3%)、Fuchs 营养不良(11.4%)和再移植(7.22%)。角膜白斑和大泡性角膜病变作为角膜移植的适应证近年来呈下降趋势(r2 = 0.60 和 r2 = 0.30)。依次增加的适应证包括 Fuchs 营养不良、再移植和角膜炎穿孔(r2 = 0.05、r2 = 0.50、r2 = 0.33)。

结论

角膜移植的数量从 2001 年到 2020 年逐渐增加。新的治疗选择,如角膜交联和巩膜镜片的发展和传播,可能导致深层前板层角膜移植的减少。穿透性角膜移植治疗失败、Fuchs 营养不良和感染性角膜炎的比例呈上升趋势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ae6/9674162/10de1d88a128/pone.0276084.g001.jpg

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