Corneal Regrafting After Endothelial Keratoplasty
Corneal Regrafting After Endothelial Keratoplasty
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DOI：
10.1097/ico.0b013e3182000add
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发表时间：
2011-05-01
期刊：
影响因子：
2.8
通讯作者：
Wilhelmus, Kirk R.
中科院分区：
文献类型：
--
作者：
Li, Jennifer Y.;Wilhelmus, Kirk R.
目的：为了确定角膜再移植后内皮角膜移植术（EK）的发病率，并探讨可能的原因，重复EK和随后的穿透性角膜移植术（PK）。方法：这项回顾性队列研究检查了角膜再移植的发生在803眼的751例患者进行初始EK从2004年1月至2009年2月使用供体角膜分布由一个单一的眼库。回归模型和生命表评估供体角膜特性的影响的概率regraft.Results：角膜再移植后EK发生在119只眼睛（15%），包括68个重复EK和51随后PK。95例（80%）再植发生在EK后1年内，39例（33%）发生在术后第一个月内。EK后三年，重复EK的累积概率为11%，后续PK的累积概率为9%。重接的长期趋势表明，从2005年到2008年，每年平均下降4%。与601例外科医生准备的组织相比，202例眼库处理的角膜的再移植几率较低（P = 0.004）。如果供体角膜在保存液中保存超过7天，则重复EK的累积概率增加（P = 0.02）。老年供体年龄，死亡保存间隔，或较低的内皮细胞密度与重复keratoplasty.Conclusions：后EK再移植是越来越不常见，可能是因为手术经验和技术创新，如眼库处理的预切组织。及时筛选和分配供体角膜可以促进移植物存活。
Purpose: To determine the incidence of corneal regrafting after endothelial keratoplasty (EK) and to explore the possible reasons for repeat EK and subsequent penetrating keratoplasty (PK).Methods: This retrospective cohort study examined the occurrence of corneal regrafts among 803 eyes of 751 patients who underwent initial EK from January 2004 through February 2009 using donor corneas distributed by a single eye bank. Regression models and life tables evaluated the effects of donor corneal characteristics on the probability of a regraft.Results: Corneal regrafting after EK occurred in 119 eyes (15%), including 68 with repeat EK and 51 with subsequent PK. Ninety-five regrafts (80%) occurred within 1 year of EK, with 39 (33%) during the first postoperative month. Three years after EK, the cumulative probability of repeat EK was 11% and was 9% for subsequent PK. The secular trend in regrafting indicated an average 4% decline per year from 2005 to 2008. The odds of regrafting occurred less often (P = 0.004) with 202 eye bank-processed corneas than with 601 surgeon-prepared tissues. The cumulative probability of repeat EK was increased if donor corneas were maintained in preservation medium for more than 7 days (P = 0.02). Older donor age, death-to-preservation interval, or lower endothelial density was not significantly associated with repeat keratoplasty.Conclusions: Regrafting after EK is becoming less common, possibly because of surgical experience and technical innovations such as eye bank processing of precut tissues. Timely screening and distribution of donor corneas may foster graft survival.