中山地区角膜移植适应证及术式变化趋势  

Indications and surgical procedures for corneal transplantation in Zhongshan Region

作　　者：钟学源 李乃洋 李凡 ZHONG Xue-yuan;LI Nai-yang;LI Fan(Guangdong Medical University,Zhanjiang 524000,Guangdong,China;不详)

机构地区：[1]广东医科大学,广东湛江524000 [2]中山市人民医院眼科中心,广东中山528403

出　　处：《广东医学》2024年第8期1065-1070,共6页Guangdong Medical Journal

基　　金：广东省基础与应用研究自然科学基金项目(面上项目)(2023A1515011225);国家自然科学基金(青年项目)(82201227)。

摘　　要：目的回顾性分析中山地区角膜移植手术适应证和手术方式的变化趋势。方法对2008年1月至2022年12月在中山市人民医院施行角膜移植手术的病例资料进行统计,分析角膜移植手术适应证和手术方式的现状及发展趋势。结果本研究共有200只眼纳入统计,其中角膜白斑51例(25.5%),感染性角膜炎45例(22.5%),眼外伤28例(14.0%),各类型角膜变性与营养不良17例(8.5%),角膜肿瘤17例(8.5%),圆锥角膜15例(7.5%),大泡性角膜病变13例(6.5%),再次手术12例(6.0%),其他角膜病变(青光眼虹膜睫状体综合征、蚕蚀性角膜溃疡)2例(1.0%)。在45例感染性角膜炎中,细菌性角膜炎31例(68.99%),真菌性角膜炎10例(22.22%),单纯疱疹病毒性角膜炎4例(8.89%)。穿透性角膜移植手术122例(61%),板层角膜移植手术66例(33%),角膜内皮移植手术10例(5%),角膜缘干细胞移植手术2例(1%)。结论中山地区角膜移植手术适应证前三位依次为角膜白斑、感染性角膜炎和外伤。穿透性角膜移植术仍是角膜移植手术的首选术式,而角膜成分移植手术的开展数量逐年增加,大大提高了供体角膜的利用率。Objective To retrospectively analyze the trends in indications and surgical procedures for corneal transplantation in the Zhongshan region.Methods Data from corneal transplantation surgeries performed at Zhongshan People's Hospital from January 2008 to December 2022 were collected and analyzed to evaluate the current status and trends in indications and surgical techniques.Results A total of 200 eyes were included in this study,with corneal leukoplakia accounting for 51 cases(25.5%),infectious keratitis 45 cases(22.5%),trauma 28 cases(14.0%),various types of corneal dystrophy and malnutrition 17 cases(8.5%),corneal tumors 17 cases(8.5%),keratoconus 15 cases(7.5%),bullous keratopathy 13 cases(6.5%),re-transplantation 12 cases(6.0%),and other corneal diseases(e.g.,glaucoma,iridocorneal endothelial syndrome,filamentary keratitis)2 cases(1.0%).Among the 45 cases of infectious keratitis,bacterial keratitis accounted for 31 cases(68.99%),fungal keratitis 10 cases(22.22%),and herpes simplex virus keratitis 4 cases(8.89%).Penetrating keratoplasty was performed in 122 cases(61%),lamellar keratoplasty in 66 cases(33%),endothelial keratoplasty in 10 cases(5%),and limbal stem cell transplantation in 2 cases(1%).Conclusion The top three indications for corneal transplantation in the Zhongshan region were corneal leukoplakia,infectious keratitis,and trauma.Penetrating keratoplasty remains the preferred surgical procedure for corneal transplantation,while the number of lamellar keratoplasty procedures has been increasing annually,significantly improving the utilization rate of donor corneas.

关 键 词：角膜移植 手术适应证 手术方式 变化趋势 

分 类 号：R779.65[医药卫生—眼科] R772.2[医药卫生—临床医学]