Wannapanich Trakanta, Puangsricharern Vilavun, Satitpitakul Vannarut, Kittipibul Thanachaporn, Suphapeetiporn Kanya
Center of Excellence for Cornea and Stem Cell Transplantation, Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Excellence Center for Cornea and Stem Cell Transplantation, Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
Clin Ophthalmol. 2025 Jan 6;19:45-57. doi: 10.2147/OPTH.S498122. eCollection 2025.
To describe the demographic profile, clinical characteristics, and treatment trends of Fuchs endothelial corneal dystrophy (FECD) in Thai patients, reflecting the evolving landscape of corneal transplantation in this region.
This retrospective cohort study included 900 patients (1,743 eyes) diagnosed with FECD at a tertiary referral center in Thailand between January 2017 and June 2023. Demographic, clinical, and surgical data were analyzed, focusing on best-corrected visual acuity (BCVA), central corneal thickness (CCT), endothelial cell density (ECD), surgical interventions, and graft survival rate.
The mean age was 63.9 years, with 77.2% of patients being female. Most eyes were classified as Adamis grade I (83.7%). Diabetes mellitus and hypertension were prevalent in 17.4% and 38.6% of patients, respectively. The rate of corneal transplantation was 8.1%, with DMEK accounting for 69.3% of transplants. Graft survival rates were 94.3% at 1 year and 76.2% at 5 years. The average post-operative ECD declined from 1667.8 ± 668.0 cells/mm² at 1 year to 1140.7 ± 684.4 cells/mm² at 5 years. Cataract surgery was performed in 20.4% of phakic eyes, with only 2.2% requiring corneal transplantation within five years.
FECD in Thailand, as reflected by this large cohort, predominantly presents at an early stage, allowing for conservative management. The growing use of DMEK highlights the shift towards less invasive procedures, mirroring global trends in Southeast Asia. These findings emphasize the importance of advancing surgical techniques and improving eye banking practices in the region.
描述泰国患者富克斯内皮性角膜营养不良（FECD）的人口统计学特征、临床特征及治疗趋势，以反映该地区角膜移植的发展态势。
这项回顾性队列研究纳入了2017年1月至2023年6月期间在泰国一家三级转诊中心诊断为FECD的900例患者（1743只眼）。对人口统计学、临床及手术数据进行分析，重点关注最佳矫正视力（BCVA）、中央角膜厚度（CCT）、内皮细胞密度（ECD）、手术干预措施及移植物存活率。
平均年龄为63.9岁，77.2%的患者为女性。大多数眼睛被分类为阿达姆斯I级（83.7%）。分别有17.4%和38.6%的患者患有糖尿病和高血压。角膜移植率为8.1%，其中 Descemet膜内皮角膜移植术（DMEK）占移植手术的69.3%。1年时移植物存活率为94.3%，5年时为76.2%。术后平均ECD从1年时的1667.8±668.0个细胞/mm²下降至5年时的1140.7±684.4个细胞/mm²。20.4%的有晶状体眼进行了白内障手术，其中只有2.2%在五年内需要角膜移植。
这一大型队列研究反映出，泰国的FECD主要在早期出现，可采用保守治疗。DMEK的使用日益增多，凸显了向侵入性较小手术的转变，这与东南亚的全球趋势一致。这些发现强调了在该地区改进手术技术和改善眼库实践的重要性。
