Limitations of Keratoplasty in China: A Survey Analysis.
Limitations of Keratoplasty in China: A Survey Analysis.
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中国角膜移植术的局限性：调查分析
DOI：
10.1371/journal.pone.0132268
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Xu J
中科院分区：
文献类型：
--
作者：
Hong J;Shi W;Liu Z;Pineda R;Cui X;Sun X;Xu J
目的中国每年进行8000多例角膜移植手术。与发达国家对角膜专家的手术经验制定了标准要求不同，中国关于角膜移植手术培训的信息很少。这项研究的目的是评估中国角膜专家的角膜移植经验，并描述他们的手术方式。方法在2014年中国角膜学会年会上，邀请16个省(65个市)的121名角膜专科医生进行匿名问卷调查，内容包括单项或多项选择题。分析了患者的人口学特征、角膜成形术的数量和类型，以及实施角膜成形术的可感知的限制因素。结果压倒性有效率为89%。在108名受访者中，76%的人在高等教育中心工作，只有23%的人拥有医学博士学位。此外，69%的参与者接受过不到一年的角膜联谊培训。只有71%的人能够进行角膜成形术。在那些做角膜移植的人中，68%的人每年进行的角膜移植手术不到50次。在同一组角膜移植外科医生中，88%的角膜专家进行过穿透性角膜成形术，87%做过板层成形术，12%做过深前板层成形术，5%做过Descemet剥离内皮成形术。当被问及中国的手术次数少的原因时，受访者认为以下因素最重要：缺乏手术培训(71%)，供体供应短缺(52%)，缺乏课程(42%)。多因素Logistic回归分析表明，角膜移植能力与应答者的教育水平和培训时间显著相关。结论中国角膜专家的角膜移植手术经验并不理想。穿透性和板层角膜成形术是首选的手术方式。我们的发现引发了人们对中国角膜移植培训充分性的担忧。
Purpose Each year, over 8,000 corneal transplantation surgeries are performed in China. Unlike developed countries, which have established standard requirements for operative experience for corneal specialists, little information exists on surgical training for keratoplasty in China. The aim of this study was to assess the keratoplasty experience of Chinese corneal specialists and to characterize their surgical patterns. Methods One hundred and twenty-one corneal specialists in 16 provinces (65 cities) in China were invited to complete an anonymous survey at the 2014 Chinese Corneal Society annual meeting, which consisted of questions with single or multiple-choice answers. Demographics, the number and type of keratoplasties performed, and the perceived limiting factors for performing keratoplasties were analyzed. Results An overwhelming 89% response rate was achieved. Of the 108 respondents, 76% worked in tertiary centers, and only 23% held a medical doctorate degree. Furthermore, 69% of the participants had received corneal fellowship training of less than one year. Only 71% were capable of keratoplasties. Among those doing keratoplasty, 68% performed less than 50 keratoplasties each year. Of the same group of keratoplasty surgeons, 88% of corneal specialists capable of keratoplasties had performed penetrating keratoplasties, 87% had performed lamellar keratoplasties, 12% had performed deep anterior lamellar keratoplasties, and 5% had performed Descemet’s stripping endothelial keratoplasties. When questioned on the reasons for the low number of keratoplasties performed in China, the respondents deemed the following factors most important: lack of surgical training (71%), a shortage of donor supply (52%), and a lack of curricula (42%). A multivariate logistic regression analysis showed that corneal transplantation capabilities are significantly associated with responders’ education levels and training time. Conclusion Keratoplasty surgery experience is suboptimal for Chinese corneal specialists. Penetrating and lamellar keratoplasties are the preferred surgical patterns. Our findings raise concerns about the adequacy of keratoplasty training in China.
影响因子：
3.9
作者：
Garg, P;Krishna, PV;Gopinathan, U
通讯作者：
Gopinathan, U
影响因子：
13.7
作者：
Reinhart, William J.;Musch, David C.;Shtein, Roni M.
通讯作者：
Shtein, Roni M.