Frequency, distribution, and outcome of keratoplasty for corneal dystrophies at a tertiary eye care center in south India
Frequency, distribution, and outcome of keratoplasty for corneal dystrophies at a tertiary eye care center in south India
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DOI：
10.1097/01.ico.0000126324.58884.b9
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发表时间：
2004-08-01
期刊：
影响因子：
2.8
通讯作者：
Rao, GN
中科院分区：
文献类型：
--
作者：
Pandrowala, H;Bansal, A;Rao, GN
目的：报告的频率，结果，和非典型组织学角膜dystrophies.Methods：角膜按钮的患者诊断为角膜营养不良的记录中指出的眼科病理登记超过6年的时间被列入本研究。对福尔马林固定、石蜡包埋组织的切片进行了专门审查，以确定沉积物类型、相关变性（如淀粉样和球状沉积物）、炎症和血管形成。必要时使用特殊染色剂，包括Masson三色、刚果红和阿尔新蓝染色。对病历进行人口统计学、临床表现、血缘关系史、家族病史和角膜移植术的临床结局（记录为清晰、营养不良复发或移植失败）评价。结果：144例患者共获得181枚钮扣，占8.3%。1%的角膜移植术在研究期间进行。患者的平均年龄为34 ± 19岁（范围3-72岁），男性：女性比例为1.6（89）：1（55）。在26%的病例中发现了血缘关系。兄弟姐妹和其他家庭成员中有类似问题的病史分别为33例（22%）和14例（9.7%）。营养不良包括黄斑（29.3%）、先天性遗传性内皮营养不良（34.8%）、Fuchs（16.6%）和格子状（15%）;其余11%包括颗粒状、凝胶状滴状、Reis-Bucklers和后部多形性营养不良。相关的组织学变化包括变性（15%）、血管化（4%）和炎症（2%）。平均随访42个月，148眼（81.7%）植片透明，33眼（18.2%）植片失败，5眼（2.8%）复发。所有营养不良的移植物存活率在1年结束时为94.3 +/-1.7%，在5年结束时为74.4 +/-4.5%。非典型的组织学特征并没有影响移植物survival.Conclusion：近亲结婚可能有助于增加在印度南部的黄斑营养不良和CHED。观察到的退行性变化可能与晚期表现或未知环境因素有关，对最终移植物结局没有影响。
Purpose: To report the frequency, outcome, and atypical histology in corneal dystrophies.Methods: Corneal buttons of patients diagnosed with corneal dystrophy as noted in the records of the ophthalmic pathology register over a period of 6 years were included in this study. The sections from formalin-fixed, paraffin-embedded tissues were reviewed specifically for the type of deposits, associated degenerations such as amyloid and spheroidal deposits, inflammation, and vascularization. Special stains including Masson trichrome, Congo red, and Alcian blue staining were used whenever required. The medical records were evaluated for demographics, clinical presentation, history of consanguinity, family medical history, and clinical outcome of keratoplasty, which was recorded as clear, recurrence of dystrophy, or graft failure. A clinicopathologic correlation was attempted.Results: A total of 144 patients contributed 181 buttons, accounting for 8. 1 % of keratoplasties performed during the study period. The mean age of the patients was 34 +/- 19 years (range 3-72 years) with a male:female ratio of 1.6 (89):1 (55). Consanguineous parentage was noted in 26% of cases. History of a similar problem in siblings and other family members was elicited in 33 (22%) and 14 (9.7%), respectively. Dystrophies included macular (29.3%), congenital hereditary endothelial dystrophy (34.8%), Fuchs (16.6%), and lattice (15%); the remaining 11% included granular, gelatinous drop-like, Reis-Bucklers, and posterior polymorphous dystrophy. Associated histologic changes were degenerations (15%), vascularization (4%), and inflammation (2%). At a mean follow-up of 42 months, the graft remained clear in 148 eyes (81.7%), failed in 33 eyes (18.2%), and recurred in 5 eyes (2.8%). Graft survival for all dystrophies at the end of 1 year was 94.3 +/- 1.7%, and at the end of 5 years was 74.4 +/- 4.5%. Atypical histologic features did not affect graft survival.Conclusion: Consanguineous marriages possibly contributed to the increase in macular dystrophy and CHED in South India. The degenerative changes seen Could possibly be related to late presentation or unknown environmental factors and do not have an effect on the ultimate graft outcome.