Indications for penetrating keratoplasty in North China
Indications for penetrating keratoplasty in North China
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DOI：
10.1097/ico.0b013e318093de07
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发表时间：
2007-10-01
期刊：
影响因子：
2.8
通讯作者：
Wang, Fuhua
中科院分区：
文献类型：
--
作者：
Xie, Lixin;Song, Zhenhua;Wang, Fuhua
目的：目的：分析我国北方地区穿透性角膜移植术（PKP）的主要适应证及其变化趋势。方法：回顾性分析1997年1月至2002年12月在山东省眼科研究所行PKP的病例资料。感染性角膜炎（真菌、细菌和棘阿米巴）、单纯疱疹性角膜炎（HSK）、角膜瘢痕形成、圆锥角膜、大泡性角膜病、再移植、角膜营养不良和变性以及其他均被纳入PKP适应症。结果：共纳入1702例（1702眼）大泡性角膜病变患者。PKP的主要适应症是感染性角膜炎（31%），其次是HSK（18%）、角膜瘢痕形成（16%）、圆锥角膜（13%）、大泡性角膜病变（7%）、再次移植（5%）和角膜营养不良和变性（4%）。圆锥角膜和大泡性角膜病变的PKP比例在6年中显著增加，而HSK和角膜瘢痕形成的PKP比例则相反。真菌感染占感染性角膜炎的66%。在118例大泡性角膜病变中，90例（76%）与白内障手术相关。再次移植的主要原因为角膜烧伤（25%）、单纯疱疹病毒性角膜炎（23%）和感染性角膜炎（14%），主要原因为免疫排斥反应（61%）、移植物感染（14%）和单纯疱疹病毒性角膜炎复发（10%）。此外，圆锥角膜和大泡性角膜病变的PKP百分比有增加的趋势。
Purpose: To analyze leading indications for penetrating keratoplasty (PKP) in north China and changing trends in them.Methods: We retrospectively reviewed the records of patients who underwent PKP at Shandong Eye Institute from January 1997 to December 2002. Infectious keratitis (fungal, bacterial, and acanthamoeba), herpes simplex keratitis (HSK), corneal scarring, keratoconus, bullous keratopathy, regrafting, corneal dystrophy and degeneration, and others were included in the indications for PKP. Initial diagnoses and causes of regrafting were recorded, as well as the related intraocular surgeries for bullous keratopathy.Results: A total of 1702 patients (1702 eyes) were included in this study. The leading indications for PKP were infectious keratitis (31%), followed by HSK (18%), corneal scarring (16%), keratoconus (13%), bullous keratopathy (7%), regrafting (5%), and corneal dystrophy and degeneration (4%). Percentage of PKP for keratoconus and bullous keratopathy increased significantly during the 6 years, contrary to HSK and corneal scarring. Fungal infections accounted for 66% of infectious keratitis. Of 118 bullous keratopathy cases, 90 (76%) were associated with cataract surgery. The leading initial diagnoses of regrafting were corneal bums (25%), HSK (23%), and infectious keratitis (14%); the major causes included immune rejection (61%), graft infection (14%), and recurrence of HSK (10%).Conclusions: Infectious keratitis remains the most common indication for PKP in north China. Moreover, there is an increasing trend in the percentage of PKP for keratoconus and bullous keratopathy.