The value of corneal transplantation in reducing blindness
The value of corneal transplantation in reducing blindness
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DOI：
10.1038/sj.eye.6701968
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发表时间：
2005-10-01
期刊：
影响因子：
3.9
通讯作者：
Gopinathan, U
中科院分区：
文献类型：
--
作者：
Garg, P;Krishna, PV;Gopinathan, U
目的 分析角膜移植术在减少角膜疾病导致的全球失明方面的作用。方法 审查已发表的文献。我们收集并分析了英语文献中发表的有关世界不同地区失明的患病率和原因、角膜失明的原因以及各种角膜疾病的角膜移植结果的文章。结果 世界上总共 80% 的盲人生活在发展中国家。视网膜疾病是经济发达国家最重要的失明原因（40-54%），而白内障（44-60%）和角膜疾病（8-25%）是经济欠发达国家最常见的失明原因。儿童期角膜炎、创伤和成年期角膜炎导致血管化角膜疤痕和粘连性白斑，是发展中国家角膜失明的最常见原因。 20% 的儿童失明是由角膜疾病造成的。近 80% 的角膜失明是可以避免的。角膜移植术治疗血管性角膜疤痕和粘连性白斑的效果并不令人满意，其中很大一部分病例需要重复手术。这些国家进行角膜移植术的其他障碍包括眼库欠佳、缺乏训练有素的人力资源和基础设施。结论 由于发展中国家承担着大部分角膜失明的负担，而角膜失明的主要原因是角膜疤痕和活动性角膜炎，因此角膜移植服务的发展需要采取全面的方法，包括眼库医疗标准、角膜专家和眼库人员的培训以及眼科医生接受角膜移植护理，以便更好地进行后续护理。然而，由于大多数角膜失明是可以预防的，因此应共同努力制定和实施预防策略。
Purpose To analyse the role of keratoplasty in reducing world blindness due to corneal diseases. Methods Review of published literature. We collected and analysed articles published in the English language literature related to the prevalence and causes of blindness in different parts of the world, causes of corneal blindness, and outcome of corneal transplantation for various corneal diseases. Results A total of 80% of the world's blind live in developing countries. Retinal diseases are the most important causes of blindness (40-54%) in established economy nations while cataract (44-60%) and corneal diseases (8-25%) are the most common causes of blindness in countries with less developed economies. Keratitis during childhood, trauma, and keratitis during adulthood resulting in a vascularized corneal scar and adherent leucoma are the most frequent causes of corneal blindness in developing countries. Corneal diseases are responsible for 20% of childhood blindness. Nearly 80% of all corneal blindness is avoidable. The outcome of keratoplasty for vascularized corneal scar and adherent leucoma is unsatisfactory, necessitating repeat surgery in a high proportion of these cases. Other barriers for keratoplasty in these nations are suboptimal eye banking, lack of trained human resources, and infrastructure. Conclusions Since the developing world carries most of the load of corneal blindness and the major causes of corneal blindness are corneal scar and active keratitis, development of corneal transplantation services need a comprehensive approach encompassing medical standards in eye banking, training of cornea specialists and eye banking personnel and exposure of ophthalmologists to care of corneal transplants for better follow-up care. However, concerted efforts should be made to develop and implement prevention strategies since most corneal blindness is preventable.