有序开展不同术式的角膜移植手术  

Attach importance to the orderly development of different corneal transplant procedures

作　　者：史伟云 李素霞 Shi Weiyun;Li Suxia(Eye Institute of Shandong First Medical University,Eye Hospital of Shandong First Medical University(Shandong Eye Hospital),State Key Laboratory Cultivation Base,Shandong Provincial Key Laboratory of Ophthalmology,School of Ophthalmology,Shandong First Medical University,Jinan 250021,China)

机构地区：[1]山东第一医科大学附属眼科研究所、山东第一医科大学附属眼科医院(山东省眼科医院)山东省眼科学重点实验室-省部共建国家重点实验室培育基地、山东第一医科大学眼科学院,济南250021

出　　处：《中华眼科杂志》2024年第2期109-112,共4页Chinese Journal of Ophthalmology

基　　金：国家自然科学基金(82271058,82271059);山东省重点研发计划(重大科技创新工程)(2022CXGC010505);泰山学者攀登计划(tspd20221110)。

摘　　要：角膜移植术有多种不同的术式,需要根据角膜各组织层混浊和病变的特点,采取精确的角膜上皮、基质(板层)、角膜内皮、全层(穿透性)角膜移植或人工角膜移植术治疗。而目前临床上存在一种倾向,即不论角膜疾病程度、是否有相应的眼库保障和手术技术条件,一概行经典的穿透性(全层)角膜移植,或者追求技术条件要求高的内皮移植和人工角膜移植等新的术式,导致术后并发症增多和角膜供体材料浪费。正确选择角膜移植术式的优点包括保留更多健康的角膜组织、节省供体、视力快速恢复、免疫排斥反应发生率低等。角膜医生需要熟练掌握各种角膜移植手术的适应证,并根据手术医生自身技术、医院和眼库的条件,有序开展不同的角膜移植术式,以提高手术成功率。There are various surgical methods for corneal transplantation,each requiring precise treatment tailored to the characteristics and different layers of corneal opacity or lesions.These layers include the corneal epithelium,stroma(lamellar),and corneal endothelium,with options for full-thickness(penetrating)corneal transplantation or artificial corneal transplantation.However,a current issue in clinical practice is that,regardless of the degree of corneal disease,the availability of corresponding eye bank support,or surgical conditions,classic penetrating(full-thickness)corneal transplantation is universally performed.Alternatively,there is a trend toward adopting technically demanding procedures such as endothelial transplantation and artificial corneal transplantation.This trend has led to increased postoperative complications and the wastage of corneal donor materials.Choosing the appropriate corneal transplant procedure can offer advantages such as preserving more healthy corneal tissue,conserving corneal donors,facilitating rapid vision recovery,and minimizing the risk of immune rejection.Corneologists need to master the indications for various corneal transplant surgeries and systematically perform different corneal transplant procedures based on the surgeon′s skills,hospital conditions,and eye bank conditions.This approach aims to enhance the success rate of the surgery。

关 键 词：角膜移植 诊疗准则(主题) 术式 

分 类 号：R779.65[医药卫生—眼科]