伊拉克角膜移植手术及其结果调查

Rafid Hameed Leki, Essa Khairan, Meqdam Dawood
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摘要

导言:角膜疾病的治疗涉及各种形式的角膜成形术。本研究旨在详细描述在伊拉克进行的各种角膜塑形手术及其相应的结果。研究方法在扎赫拉教学医院开展了一项观察性研究,记录角膜塑形术病例。收集的数据包括年龄、性别、角膜塑形术类型、适应症、既往手术史或病史以及术后效果。角膜塑形术的类型包括穿透性角膜塑形术(PKP)、深前片状角膜塑形术(DALK)和戴斯麦剥离内皮角膜塑形术(DSEK)。此外,我们还为白内障患者实施了白内障手术和眼内人工晶体(IOL)植入术,使用巩膜固定的人工晶体或虹膜固定的人工晶体。我们在接到采购订单后的第一天、第一周、第一个月以及之后每六个月完成一次任务。在手术前,有角膜血管的患者要对角膜血管进行激光光凝。结果:年龄从 4 岁到 90 岁不等。40岁以上(60.8%)是最常见的年龄组。女性发病率为 52.9%。51.6%的患者被诊断为右眼患病。60%的患者接受了PKP手术。26.8%的患者接受了DALK,12.4%的患者接受了DSEK。角膜移植术后,最佳矫正视力(BCVA)改善率为 68.5%,而 BCVA 下降的眼睛占 12.2%,BCVA 无变化的眼睛占 19.3%。术后,视力持续时间低于 1 年的病例 BCVA 明显降低(1.5),视力持续时间大于 3 年的病例 BCVA 明显提高(0.5)。感染性角膜炎(-0.7)、角膜营养不良(-0.6)和晚期角膜病(-0.7)病例的视力改善幅度最大,而移植排斥(-0.3)和大泡性角膜病(-0.3)病例的视力改善幅度最小:在年轻人群中,角膜移植手术可显著提高视力。感染性角膜炎、角膜炎和角膜营养不良产生的效果最为理想和卓越。PKP 方法是最常用的方法。
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An Investigation of Keratoplasty Procedures and Their Outcomes in Iraq
Introduction: The treatment of corneal disorders involves the use of various forms of keratoplasty. The objective of this study was to provide a detailed description of the various types of keratoplasty procedures performed in Iraq, as well as their corresponding outcomes. Methods: An observational study was conducted at Al-Zahraa Teaching Hospital to document cases of keratoplasty. The collected data included age, gender, types of keratoplasty, indications, previous surgical or medical history, and postoperative outcomes. The types of keratoplasty included penetrating keratoplasty (PKP), deep anterior lamellar keratoplasty (DALK), and Descemet's stripping endothelial keratoplasty (DSEK). Additionally, we performed cataract surgery and intraocular lens (IOL) insertion for those with cataracts, using either IOLs with scleral fixation or IOLs with iris fixation. We complete the task on the first day following the purchase order, then the first week, the first month, and every six months thereafter. Prior to surgery, patients with corneal vascularization had laser photocoagulation of the blood vessels in the cornea. Results: Ages range from 4 to 90. People over 40 (60.8%) were the most common age group. The female prevalence was 52.9%. Right-eye illness was diagnosed 51.6% of the time. 60% of patients underwent PKP. 26.8% had DALK, 12.4% had DSEK. Post keratoplasty, the statistically-significant improvement-ratio was 68.5% as eyes best corrected visual acuity (BCVA) improvement, while 12.2% of eyes showed a decline in BCVA and 19.3% discharged with no changes in BCVA. Postoperatively, BCVA was significantly lower in cases with a duration below 1 year (1.5), and better among the duration > 3 years (0.5). The greatest improvements were seen in cases with infective keratitis (-0.7), corneal dystrophies (-0.6), and advanced keratoconus (-0.7) whereas the lowest rates were documented in cases with a graft rejection (-0.3), and bullous keratopathy (-0.3) Conclusion: Keratoplasty is associated with a substantial enhancement of visual acuity in the younger population. Infective keratitis, keratoconus, and corneal dystrophy produce the most optimal and superior results. The PKP method is the most frequently performed.
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