Yan Chunxiao, Zhang Zhijian, Jin Lin, Liu Mengxin, Wang Tianyi, Yang Jinghao, Zhang Lijun
Dalian Medical University, Dalian, China.
Department of Ophthalmology, The Third People's Hospital of Dalian Affiliated to Dalian Medical University, Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Liaoning Provincial Optometry Technology Engineering Research Center, Dalian, China.
Front Med (Lausanne). 2025 Jan 8;11:1517198. doi: 10.3389/fmed.2024.1517198. eCollection 2024.
The study aimed to review the etiology of corneal blindness and investigate the relative risk of corneal graft rejection (CGR) in the southern Liaoning region.
The clinical records of 359 patients (394 eyes) who underwent corneal transplantation at the Department of Keratoconus of the Third People's Hospital of Dalian from January 2019 to December 2023 were retrospectively analyzed. The data included patients' age, gender, occupation, diagnosis, surgical procedure, postoperative immune rejection, and neovascularization. The data were collected and descriptively analyzed to characterize the etiology of corneal blindness and to analyze the risk factors for postoperative immune rejection after corneal transplantation using logistic regression.
The mean age of the patients who underwent corneal transplantation was 55.90 ± 0.80 years, and there were more male patients than female patients with corneal blindness. Infectious keratitis (41.1%) was reported as the leading cause of corneal blindness, and penetrating corneal transplantation was the main surgical procedure for the recovery of sight. Preoperative corneal vascularization and penetrating corneal graft rejection were identified as risk factors for immune rejection of corneal grafts. The preoperative corneal vascularization was performed ( = 0.044, OR = 2.607). Penetrating keratoplasty (PKP) was performed ( = 0.024, OR = 1.953), and deep anterior lamellar keratoplasty was also performed ( = 0.801, OR = 1.088). Viral infections ( < 0.001, OR = 16.871) were the major risk factor for preoperative corneal neovascularization (CNV) compared to other etiologies, such as fungal infections ( < 0.001, OR = 0.018), mechanical ocular trauma ( < 0.001, OR = 0.034), immune keratitis ( = 0.023, OR = 0.152), and endothelial dysfunction ( < 0.001, OR = 0.054).
Infectious keratitis was identified as the major cause of corneal blindness in the southern Liaoning region over the past 5 years. Penetrating keratoplasty and preoperative corneal vascularization were the risk factors for corneal graft rejection. In addition, virus-derived keratitis was considered to be the main risk factor for corneal neovascularization, and deep anterior lamellar keratoplasty was not found to have an effect on corneal graft rejection in this study.
本研究旨在回顾角膜盲的病因，并调查辽南地区角膜移植排斥反应（CGR）的相对风险。
回顾性分析2019年1月至2023年12月在大连第三人民医院圆锥角膜科接受角膜移植的359例患者（394只眼）的临床记录。数据包括患者的年龄、性别、职业、诊断、手术方式、术后免疫排斥反应和新生血管形成情况。收集并对数据进行描述性分析，以明确角膜盲的病因，并使用逻辑回归分析角膜移植术后免疫排斥反应的危险因素。
接受角膜移植患者的平均年龄为55.90±0.80岁，角膜盲患者中男性多于女性。感染性角膜炎（41.1%）被报告为角膜盲的主要原因，穿透性角膜移植是恢复视力的主要手术方式。术前角膜新生血管形成和穿透性角膜移植排斥反应被确定为角膜移植免疫排斥反应的危险因素。术前存在角膜新生血管形成（P = 0.044，OR = 2.607）。进行了穿透性角膜移植术（PKP）（P = 0.024，OR = 1.953），也进行了深板层角膜移植术（P = 0.801，OR = 1.088）。与其他病因相比，病毒感染（P < 0.001，OR = 16.871）是术前角膜新生血管形成（CNV）的主要危险因素，其他病因包括真菌感染（P < 0.001，OR = 0.018）、机械性眼外伤（P < 0.001，OR = 0.034）、免疫性角膜炎（P = 0.023，OR = 0.152）和内皮功能障碍（P < 0.001，OR = 0.054）。
感染性角膜炎被确定为过去5年辽南地区角膜盲的主要原因。穿透性角膜移植术和术前角膜新生血管形成是角膜移植排斥反应的危险因素。此外，病毒源性角膜炎被认为是角膜新生血管形成的主要危险因素，本研究未发现深板层角膜移植术对角膜移植排斥反应有影响。
