Williams K A, Muehlberg S M, Lewis R F, Coster D J
Department of Ophthalmology, Flinders University of South Australia, Australia.
Br J Ophthalmol. 1997 Oct;81(10):835-9. doi: 10.1136/bjo.81.10.835.
The aims of this study were to examine the influence of advanced recipient and donor age on the long term outcome of corneal transplantation.
Records of 1036 penetrating corneal grafts in recipients aged > or = 80 years at surgery (defined as the elderly subset) and 8092 donor corneas used for transplantation were obtained from the Australian Corneal Graft Register database, Kaplan-Meier graft survival plots were compared using log rank statistics.
Elderly recipients constituted 15% of the recipient pool. The major indication for corneal transplantation in the elderly was bullous keratopathy. Graft survival fell with increasing recipient age (p < 0.00001); the major cause of graft failure was rejection (33%). The desired outcome in 51% of cases was to improve vision and in 42% of cases to relieve pain; 23% of elderly recipients achieved a Snellen acuity of 6/18 or better in the grafted eye and 66% recorded improved acuity after transplantation. Elderly recipients suffered more complications and comorbidities in the grafted eye than did younger recipients. Donor age (stratified in 10 year intervals) did not influence corneal graft survival significantly (p = 0.10).
Elderly graft recipients fared less well after corneal transplantation than did younger recipients, but outcomes in terms of long term graft survival and visual rehabilitation were still good. Donor age did not affect graft survival.
本研究旨在探讨高龄受体和供体年龄对角膜移植长期预后的影响。
从澳大利亚角膜移植登记数据库中获取1036例手术时年龄≥80岁的受体（定义为老年亚组）穿透性角膜移植记录以及8092例用于移植的供体角膜记录，采用对数秩统计比较Kaplan-Meier移植存活曲线。
老年受体占受体总数的15%。老年患者角膜移植的主要指征是大泡性角膜病变。移植存活率随受体年龄增加而下降（p<0.00001）；移植失败的主要原因是排斥反应（33%）。51%的病例期望改善视力，42%的病例期望缓解疼痛；23%的老年受体移植眼的Snellen视力达到6/18或更好，66%的患者移植后视力有所提高。老年受体移植眼比年轻受体遭受更多的并发症和合并症。供体年龄（按10年间隔分层）对角膜移植存活率无显著影响（p=0.10）。
老年角膜移植受体术后情况不如年轻受体，但长期移植存活和视力康复方面的预后仍然良好。供体年龄不影响移植存活。
