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角膜移植中的可持续性与成本优化策略:外科医生视角

Strategies for Sustainability and Cost Optimization in Corneal Transplantation: From Surgeons’ Perspective.

作者信息

Kıyat Pelin, Palamar Melis

机构信息

İzmir Democracy University, Buca Seyfi Demirsoy Training and Research Hospital, Clinic of Ophthalmology, İzmir, Türkiye

Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Türkiye

出版信息

Turk J Ophthalmol. 2025 Feb 27;55(1):29-35. doi: 10.4274/tjo.galenos.2024.89170. Epub 2025 Feb 5.

DOI:10.4274/tjo.galenos.2024.89170
PMID:39905960
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11866992/
Abstract

The main purpose of this review is to provide an overview of surgical strategies that can be implemented in keratoplasty to maximize resource utilization and enhance sustainability. To achieve this, we conducted a thorough search of PubMed to identify articles on sustainability and cost-effectiveness in surgical settings, as well as studies comparing the cost-effectiveness of different keratoplasty techniques. Our review shows that both penetrating keratoplasty and lamellar techniques are cost-effective. However, lamellar techniques offer greater long-term sustainability and cost efficiency in addition to improving patient vision. For corneal transplantation surgeries, strategies such as reducing operating room time, properly educating the surgical team, reusing instruments like trephines and punches, using surgical materials economically, and selecting the appropriate surgical technique are recommended to enhance sustainability and reduce costs. The strategies outlined could contribute to more sustainable practices in keratoplasty procedures. In conclusion, although ensuring the economical use of surgical materials is beneficial for improving sustainability and reducing costs during surgery, utmost care should be taken to preserve safety and effectiveness while taking measures to reduce costs, and a balance should be achieved between sustainability and patient safety.

摘要

本综述的主要目的是概述可在角膜移植术中实施的手术策略,以最大限度地提高资源利用率并增强可持续性。为此,我们对PubMed进行了全面检索,以识别关于手术环境中的可持续性和成本效益的文章,以及比较不同角膜移植技术成本效益的研究。我们的综述表明,穿透性角膜移植术和板层技术都具有成本效益。然而,板层技术除了能改善患者视力外,还具有更高的长期可持续性和成本效益。对于角膜移植手术,建议采取减少手术时间、对手术团队进行适当培训、重复使用环钻和冲孔器等器械、经济地使用手术材料以及选择合适的手术技术等策略,以增强可持续性并降低成本。所概述的策略有助于角膜移植手术中更可持续的实践。总之,虽然确保手术材料的经济使用有利于提高可持续性并降低手术成本,但在采取降低成本措施时,应格外小心以确保安全和有效性,并在可持续性和患者安全之间取得平衡。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74cc/11866992/8096b7ea5767/TurkJOphthalmol-55-1-29-figure-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74cc/11866992/8096b7ea5767/TurkJOphthalmol-55-1-29-figure-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74cc/11866992/8096b7ea5767/TurkJOphthalmol-55-1-29-figure-1.jpg

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Cornea. 2024 Oct 2. doi: 10.1097/ICO.0000000000003707.
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Surgical Marking Pen Contamination: Writing a Postoperative Infection Into Your Preoperative Plan.手术标记笔污染:将术后感染写入术前计划
Cureus. 2023 Jun 5;15(6):e40007. doi: 10.7759/cureus.40007. eCollection 2023 Jun.
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Reducing Disposable Surgical Items: Decreasing Environmental Impact and Costs at a Children's Hospital, a Pilot Study.减少一次性手术器械:儿童医院的试点研究减少环境影响和成本。
J Surg Res. 2023 Aug;288:309-314. doi: 10.1016/j.jss.2023.02.035. Epub 2023 Apr 12.
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Environmental impact of single-use and reusable flexible cystoscopes.一次性和可重复使用的软性膀胱镜的环境影响。
BJU Int. 2023 May;131(5):617-622. doi: 10.1111/bju.15949. Epub 2023 Jan 2.
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The impact of switching from single-use to reusable healthcare products: a transparency checklist and systematic review of life-cycle assessments.从一次性使用到可重复使用的医疗保健产品的影响:透明度清单和生命周期评估的系统评价。
Eur J Public Health. 2023 Feb 3;33(1):56-63. doi: 10.1093/eurpub/ckac174.
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Trial-based cost-effectiveness analysis of Descemet membrane endothelial keratoplasty (DMEK) versus ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK).基于试验的Descemet膜内皮角膜移植术(DMEK)与超薄Descemet膜剥除自动内皮角膜移植术(UT-DSAEK)的成本效益分析。
Acta Ophthalmol. 2023 May;101(3):319-329. doi: 10.1111/aos.15280. Epub 2022 Oct 31.
7
Addressing the environmental sustainability of eye health-care delivery: a scoping review.探讨眼保健服务的环境可持续性:范围综述。
Lancet Planet Health. 2022 Jun;6(6):e524-e534. doi: 10.1016/S2542-5196(22)00074-2.
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Eur Urol. 2023 Apr;83(4):331-342. doi: 10.1016/j.eururo.2022.01.027. Epub 2022 Feb 10.
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A simple surgical technique for splitting a single donor cornea for performing deep anterior lamellar keratoplasty and Descemet membrane endothelial keratoplasty without using a microkeratome.一种简单的手术技术,用于将单个供体角膜分割开,以进行深层前板层角膜移植术和 Descemet 膜内皮角膜移植术,而无需使用微型角膜刀。
Indian J Ophthalmol. 2021 Sep;69(9):2441-2445. doi: 10.4103/ijo.IJO_3044_20.