Clinical Characteristics and Outcomes of Short-term Repeat Corneal Transplantation
Clinical Characteristics and Outcomes of Short-term Repeat Corneal Transplantation
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DOI：
10.1080/09273948.2020.1838557
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发表时间：
2021-02
影响因子：
3.3
通讯作者：
Xiunian Chen;Ting Li;X. Qi;W. Shi;Hua Gao
中科院分区：
文献类型：
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作者：
Xiunian Chen;Ting Li;X. Qi;W. Shi;Hua Gao
摘要目的探讨短期再次角膜移植的适应证、直接原因及移植片存活率。方法采用横断面分析研究。结果角膜移植术的主要适应证为感染性角膜炎（67.9%）和免疫性角膜病变（12.8%）。移植失败的直接原因是感染性溃疡（43.6%）和复发（30.8%）。术前前房积脓（P = 0.017，HR = 1.757）和使用脱细胞猪角膜作为移植物（P = 0.005，HR = 2.690）是移植失败的独立风险因素。Kaplan-Meier分析显示88例重复移植的1年生存率为85.2%，5年生存率为79.2%。重复移植的成活率明显高于首次移植（P < 0.001）。结论感染性角膜炎是近期植片失败的最常见指征，常因感染性溃疡和角膜炎复发而失败。虽然脱细胞猪角膜在发展中国家是一个有前途的应用，但某些困难，如移植物熔化，仍然没有得到解决。
ABSTRACT Purpose To explore the primary indications, direct causes and graft survival of short-term repeat keratoplasty. Methods An analytical cross-sectional study. Results The primary indications for keratoplasty were infectious keratitis (67.9%) and immune keratopathy (12.8%). The direct causes of graft failure were infectious ulcer (43.6%) and recurrence (30.8%). Pre-operative hypopyon (P = 0.017, HR = 1.757) and use of decellularized porcine corneas as grafts (P = 0.005, HR = 2.690) were independent risk factors for graft failure. The Kaplan–Meier analysis revealed that the 1-year survival rate of 88 repeat grafts was 85.2%, and the 5-year survival rate was 79.2%. The survival rates of the repeat grafts were significantly higher than those of the first grafts (P < 0.001). Conclusion Infectious keratitis is the most common indication of short-term graft failure and is often failed by infectious ulcer and keratitis recurrence. While the decellularized porcine cornea is a promising application in developing countries, certain difficulties, such as graft melting, remain unresolved.