Evolving Indications for and Trends in Keratoplasty in British Columbia, Canada, From 2002 to 2011: A 10-Year Review
Evolving Indications for and Trends in Keratoplasty in British Columbia, Canada, From 2002 to 2011: A 10-Year Review
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DOI：
10.1097/ico.0000000000000066
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发表时间：
2014-03-01
期刊：
影响因子：
2.8
通讯作者：
Yeung, Sonia N.
中科院分区：
文献类型：
--
作者：
Tan, Johnson C. H.;Holland, Simon P.;Yeung, Sonia N.
目的：本研究的目的是报道加拿大不列颠哥伦比亚省从2002年到2011年10年间角膜移植适应症的演变和角膜移植类型的转变。方法：对加拿大不列颠哥伦比亚省眼库从2002年1月到2011年12月的所有角膜移植组织的记录进行了回顾。结果：2002年1月至2011年12月，3742例患者(男1968例，女1774例)共进行了4843例角膜移植手术。2008年进行的角膜成形术数量为420例，2011年为578例。在过去10年中，排名前4位的适应症是Fuchs内皮营养不良(FED；18.9%)、无晶状体/人工晶状体大泡性角膜病变(17.4%)、再植入术(17.1%)和圆锥角膜(15.5%)。穿透性角膜移植(PKP)占全部角膜成形术的86.5%(4191例)。自2007年引入Descemet剥离自动内皮角膜移植(DSAEK)以来，进行的DSAEK(P<；0.0001)的数量显著增加，而进行的PKP(P<；0.0001)的数量在统计学上下降。尽管只进行了30例深板层角膜成形术，但2008年以后有增加的趋势(P=0.0087)。FED、无晶状体/人工晶状体大泡性角膜病变及植入术的PKP呈下降趋势，DSAEK呈上升趋势。结论：FED已成为近10年来角膜移植的首选适应症。因内皮功能衰竭而行的PKP手术改为DSAEK手术。尽管深前板层角膜移植手术的数量很少，但有显著的增加趋势。
Purpose:The aim of this study was to report the evolving indications for keratoplasty and the shift in the type of keratoplasty performed in British Columbia, Canada, over a 10-year period from 2002 to 2011.Methods:This was a retrospective database review of all the records of corneal transplant tissues at the Eye Bank of British Columbia, Canada, from January 2002 to December 2011. The patient demographics, indications, and types of transplant performed were analyzed.Results:A total of 4843 corneal transplants were performed in 3742 patients (1968 male and 1774 female) from January 2002 to December 2011. The number of keratoplasties performed ranged from 420 in 2008 to 578 in 2011. The top 4 indications over the 10-year period were Fuchs endothelial dystrophy (FED; 18.9%), aphakic/pseudophakic bullous keratopathy (17.4%), regraft (17.1%), and keratoconus (15.5%). Penetrating keratoplasty (PKP) accounted for 86.5% (4191 transplants) of all keratoplasties performed. Since the introduction of Descemet stripping automated endothelial keratoplasty (DSAEK) in 2007, there was a significant increase in the number of DSAEKs (P < 0.0001) performed and a statistical decline in the number of PKPs (P < 0.0001) performed. Despite only 30 deep anterior lamellar keratoplasties being performed, an increasing trend was observed after 2008 (P = 0.0087). A decreasing trend in PKPs and an increasing trend in DSAEKs were observed for surgeries performed for FED, aphakic/pseudophakic bullous keratopathy, and regraft.Conclusions:FED has become the top indication for performing a keratoplasty over the 10-year period. There was a shift from PKP to DSAEK performed for endothelial failure. Although the number of deep anterior lamellar keratoplasty surgeries was small, there was a significant increasing trend.