Alternatives to allograft corneal transplantation
Alternatives to allograft corneal transplantation
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DOI：
10.1097/icu.0b013e32833a8dd3
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发表时间：
2010-07-01
影响因子：
3.7
通讯作者：
Vajpayee, Rasik B.
中科院分区：
文献类型：
--
作者：
Jhanji, Vishal;Sharma, Namrata;Vajpayee, Rasik B.
综述目的角膜移植是世界上最常用的实体器官移植。尽管传统的角膜移植手术已有100多年的辉煌历史，但由于长期使用局部皮质类固醇，导致移植物排斥反应、移植物感染和相关青光眼等问题，使其成功受到影响。此外，在世界上的一些地区，供体角膜组织缺乏，这随后每年增加了眼库的现有负担。我们提出了替代传统的角膜移植手术的管理角膜瘢痕。Recent findingsThe潜在的使用替代异体角膜移植手术已被世界各地的角膜外科医生描述。这些技术包括非手术干预，如接触透镜拟合。手术方法包括准分子激光角膜切削术、光学虹膜切除术、旋转自体角膜移植术和对侧自体角膜移植术。虽然这些技术不实行常规，然而，他们的适当利用将明确帮助角膜外科医生摆脱某些问题与同种异体角膜transplantation. SummaryCarefully选择患者可以产生令人鼓舞的结果与使用这些替代技术。视力结果可能不如常规角膜移植术后好;然而，这种挫折被优点所抵消，例如没有角膜移植排斥反应。我们还相信，这些技术的使用将至少部分解决发展中国家供体角膜组织稀缺的问题。
Purpose of reviewCorneal transplantation is the most commonly performed solid organ transplantation in the world. Despite a glorious history of more than a 100 years, the success of conventional corneal transplantation surgery is marred by problems like graft rejection, graft infection and associated glaucoma due to long-term use of topical corticosteroids. In addition there is a dearth of donor corneal tissue in some parts of the world which subsequently adds on to the existing burden on the eye banks every year. We propose alternatives to the conventional corneal transplantation surgery for the management of corneal scarring.Recent findingsThe potential use of alternatives to allograft corneal transplantation surgery has been described by corneal surgeons around the world. These techniques consist of nonsurgical interventions like contact lens fitting. Surgical alternatives include excimer laser phototherapeutic keratectomy, optical iridectomy, rotational autokeratoplasty and contralateral autokeratoplasty. Although these techniques are not practiced routinely, however, their appropriate utilization would clearly help the corneal surgeons to get rid of certain problems associated with allograft corneal transplantation.SummaryCareful selection of patients can yield encouraging results with the use of these alternative techniques. Visual outcomes may not be as good as after a routine keratoplasty; nevertheless, this setback is outweighed by advantages such as absence of corneal graft rejection. We also believe that the use of these techniques would at least partially resolve the issue of scarcity of donor corneal tissue in the developing world.