[影响反复穿透性角膜移植术疗效的因素]。

Nippon Ganka Gakkai zasshi Pub Date : 2015-09-01
Shinobu Yamamoto, Machiko Shimmura-Tomita, Yoshiyuki Satake, Seika Shimazaki-Den, Shigeto Shimmura, Jun Shimazaki
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引用次数: 0

摘要

目的:探讨反复穿透性角膜移植术(PKP)的预后及影响因素。方法:回顾性分析106例重复PKP患者108眼的移植物存活率、术后1年最佳矫正视力和不可逆排异率。对年龄、既往PKP次数、原发疾病、青光眼史、排斥反应史、术后免疫抑制剂使用情况等可能影响预后的因素也进行了研究。结果:个体因素分析显示排斥史和术后免疫抑制剂显著增加术后排斥风险。多因素分析显示,在使用全身免疫抑制剂(类固醇和环孢素)的病例中,移植物存活率显著降低。有青光眼病史的患者术后一年最佳矫正视力明显较差。在有排斥史的病例中,术后全身给予免疫抑制剂与术后不可逆排斥反应显著相关。结论:有排斥反应和青光眼病史的患者预后较差,术后使用免疫抑制剂不能改善预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Factors Affecting Outcomes of Repeated Penetrating Keratoplasty].

Purpose: To investigate prognosis for repeated penetrating keratoplasty (PKP) and factors that affect the outcome.

Methods: We retrospectively investigated graft survival rates, 1-year postoperative best-corrected visual acuity and irreversible rejection rates in 108 eyes of 106 patients that had repeated PKP. Factors that might affect the outcome were, age, number of previous PKP, original diseases, history of glaucoma and rejection and the use of postoperative immunosuppressant were also studied.

Results: Individual-factor analysis showed that history of rejection and postoperative immunosuppressant significantly increased the risk of postoperative rejection. Multi-factor analysis showed that graft survival rate was significantly lower among cases that had systemic immunosuppressants (steroids and cyclosporine). One year postoperative best-corrected visual acuity was significantly worse in cases that had history of glaucoma. In cases with history of rejection, systemic administration of postoperative immunosuppressants was significantly associated with postoperative irreversible rejection.

Conclusion: History of rejection and glaucoma tend to have poor outcome, and the outcome might not improve by postoperative immunosuppressants.

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