Zhou Yujia, Wang Theodore, Tuli Sonal S, Steigleman Walter A, Shah Ankit A
University of Florida Shands Hospital, Gainesville, FL.
Transplant Direct. 2023 Jan 12;9(2):e1434. doi: 10.1097/TXD.0000000000001434. eCollection 2023 Feb.
Corneal transplant is a procedure that aims to replace dysfunctional corneal tissue with a transparent graft and is one of the most widely performed transplant surgeries, but its public and professional awareness is low outside of ophthalmology. Corneal tissue consists of 5 major layers that serve to maintain its structural integrity and refractive shape: the epithelium, Bowman's layer, the stroma, Descemet's membrane, and the endothelium. Failure or irreversible damage to any layer of the cornea may be an indication for corneal transplant, and variants of this procedure may be full thickness or selectively lamellar. Complications related to corneal transplantation may occur anywhere from during surgery to years afterward, including rejection, dehiscence, cataract, and glaucoma. Complications should be managed by an ophthalmologist, but other physicians should be aware of prophylactic medications. Topical immunosuppressants and steroids are effective for preventing and treating rejection episodes, whereas there is little evidence to support the use of systemic immunosuppression. Eye protection is recommended for any corneal transplant recipient. Physicians should counsel patients on corneal donation, especially if outside the United States, where donor tissue is in short supply.
角膜移植是一种旨在用透明移植物替换功能失调的角膜组织的手术，是实施最为广泛的移植手术之一，但在眼科领域之外，公众和专业人士对其认知度较低。角膜组织由5个主要层次组成，这些层次有助于维持其结构完整性和屈光形状：上皮层、Bowman层、基质层、Descemet膜和内皮细胞层。角膜任何一层出现功能衰竭或不可逆转的损伤都可能是角膜移植的指征，该手术的变体可以是全层移植或选择性板层移植。与角膜移植相关的并发症可能在手术期间至术后数年的任何时间出现，包括排斥反应、裂开、白内障和青光眼。并发症应由眼科医生处理，但其他医生也应了解预防性用药。局部免疫抑制剂和类固醇对预防和治疗排斥反应有效，而几乎没有证据支持使用全身免疫抑制。建议任何角膜移植受者进行眼部保护。医生应向患者提供有关角膜捐赠的咨询，特别是在美国以外的地区，那里供体组织短缺。
