Τομέας ΧειρουργικήςLibrary of the School of Health Sciences
Κουτσανδρέα Χρυσάνθη, Καθηγήτρια, Ιατρική, ΕΚΠΑ
Λαδάς Ιωάννης, Καθηγητής, Ιατρική, ΕΚΠΑ
Γεωργάλας Ηλίας, Αν. Καθηγητής, Ιατρική, ΕΚΠΑ
Μπρούζας Δημήτριος, Αν. Καθηγητής, Ιατρική, ΕΚΠΑ
Παπακωνσταντίνου Δημήτριος, Αν. Καθηγητής, Ιατρική, ΕΚΠΑ
Σίασος Γεράσιμος, Αν. Καθηγητής, Ιατρική, ΕΚΠΑ
Χατζηστεφάνου Κλειώ, Επικ. Καθηγήτρια, Ιατρική, ΕΚΠΑ
Ενδείξεις και χειρουργικές τεχνικές μεταμόσχευσης κερατοειδούς - Αναδρομική μελέτη 16 ετών
Indications and techniques of corneal transplantation - Retrospective study of 16 years
Introduction: It is common to note that corneal transplantation has evolved rapidly in recent years. The development of new lamellar techniques of corneal transplantation has yielded results equivalent or superior to those of penetrating keratoplasty, with regard to postoperative visual acuity, even with reduced risk of complications.
Purpose: Aim of the present study is to describe the evolution of indications and techniques of keratoplasty procedures in the largest transplantation center in Greece over a period of 16 years.
Methods: All patients who underwent corneal transplantation from 2000 to 2015 in the two ophthalmology clinics of General Hospital of Athens, G. Gennimatas were retrospectively reviewed. The main data analyzed was the annual incidence of various keratoplasty indications and techniques, as well as their respective trends over time.
Results: A total of 1256 keratoplasty procedures were performed by three surgeons. Mean recipient age was 62.5 ± 4.7 years. The most common indications were bullous keratopathy (38.4%), followed by regraft (18.6%), corneal scar (10.3%), keratoconus (9.6%), Fuchs’ dystrophy (9.6%).
In addition, there was a decreasing tendency of keratoconus (P=0.009), whereas bullous keratopathy (P=0.003) and Fuchs' dystrophy (P=0.001) showed an increasing trend.
In terms of keratoplasty techniques, penetrating keratoplasty was the only technique from 2000 to 2009 (when the first lamellar keratoplasty was performed in our hospital) and was limited to 21.4% in the last year of our study. In the same year, DSAEK was the most commonly performed keratoplasty technique (59.8%) and the corresponding percentage of DMEK was 18.8%.
Conclusion: Leading indication at our center was bullous keratopathy with increasing trend over the observation period. A tremendous shift from penetrating keratoplasty to more selective techniques such as DSAEK and DMEK was observed, with both techniques having become procedures of choice in the treatment of corneal endothelial disease.
Main subject category:
Penetrating keratoplasty, Corneal transplantation, Lamellar keratoplasty, Keratoplasty indications
Number of references:
ΔΙΑΤΡΙΒΗ_ΜΠΑΤΖΙΚΟΣ ΓΕΩΡΓΙΟΣ final.pdf
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