Abstract:
BACKGROUND:Keratoplasty is considered the most frequently performed type of transplantation in humans. Traditionally, penetrating keratoplasty has been the most common procedure. However, over the last 15 years, the importance of posterior lamellar keratoplasty has increased for the treatment of Fuchs endothelial dystrophy and bullous keratopathy. In Germany, based on national surveys, it was suggested that there was a trend towards lamellar keratoplasty. OBJECTIVE:The main objective of this study was to determine whether the proportion of lamellar keratoplasties carried out in Germany between 2006 and 2017 had increased. Furthermore, the number of keratoplasties carried out as HLA-matched (HLA: human leukocyte antigen) keratoplasties should be calculated. MATERIALS AND METHODS:The numbers of all keratoplasties carried out as lamellar/penetrating and HLA-matched keratoplasties was extracted from the hospital quality reports published between 2006 and 2017. Descriptive statistical analysis was carried out in R (www.r-project.org). RESULTS:Between 2006 and 2017, 43,021 keratoplasties were carried out in Germany. The number of keratoplasties increased from 2,849 (2006) to 8,231 (2017). The number of penetrating keratoplasties remained stable. The proportion of lamellar keratoplasties increased from 6.5% (2006) to 61.4% (2017). The proportion of HLA-matched keratoplasties was below 20% and declined between 2010 and 2017 (2010: 19.7%; 2017: 9.8%). DISCUSSION:In Germany, posterior lamellar keratoplasty has become increasingly important. Since 2014, the number of lamellar keratoplasties has exceeded the number of penetrating keratoplasties. However, the number of penetrating keratoplasties remained stable between 2006 and 2017 and still plays an important role in the management of patients with predominantly stromal or corneal defects affecting all layers. The decreasing number of HLA-matched keratoplasties is most likely due to the lack of clear evidence of a significant reduction in the rejection rates in cases of normal risk keratoplasty. HINTERGRUND:Die Keratoplastik zählt weltweit zu den am häufigsten durchgeführten Gewebetransplantationen. Traditionell entfiel die überwiegende Mehrheit der Eingriffe auf die perforierende Keratoplastik. Mit deren Weiterentwicklung in den vergangenen 15 Jahren gewann jedoch insbesondere die posteriore lamellierende Keratoplastik zur Behandlung der Fuchs-Endotheldystrophie sowie der bullösen Keratopathie zunehmend an Bedeutung. Basierend auf informellen Umfrageergebnissen wurde postuliert, dass sich auch in Deutschland ein Trend hin zur posterioren lamellierenden Keratoplastik abzeichnet. ZIEL DER ARBEIT:Anhand der Qualitätsberichte der Krankenhäuser sollte geprüft werden, ob der Anteil der lamellierenden Keratoplastik in Deutschland im Zeitraum 2006 bis 2017 zugenommen hat. Zudem sollte die Zahl der HLA-kompatibel (HLA: humanes Leukozytenantigen) durchgeführten Keratoplastiken ermittelt werden. MATERIAL UND METHODEN:Die Operationszahlen der perforierend/lamellierend bzw. HLA-kompatibel durchgeführten Keratoplastiken wurden anhand der OPS-Ziffern aus den Krankenhausqualitätsberichten der Jahre 2006 bis einschließlich 2017 extrahiert. Die deskriptive statistische Auswertung erfolgte mit dem Softwarepaket R (www.r-project.org). ERGEBNISSE:Von 2006 bis 2017 wurden deutschlandweit insgesamt 43 021 Keratoplastiken durchgeführt. Die Zahl der durchgeführten Keratoplastiken stieg von 2849 im Jahr 2006 auf 8231 im Jahr 2017. Die absolute Zahl perforierender Keratoplastiken blieb insgesamt konstant. Der relative Anteil lamellierender Keratoplastiken stieg von 6,5% (2006) auf 61,4% (2017) an. Die Zahl der HLA-kompatibel durchgeführten Keratoplastiken lag stets unter 20% und war ab 2010 rückläufig (2010: 19,7%; 2017: 9,8%). DISKUSSION:Die posteriore lamellierende Keratoplastik hat auch in Deutschland stark an Stellenwert gewonnen und seit 2014 die perforierende Keratoplastik als häufigste Form der Keratoplastik abgelöst. Die perforierende Keratoplastik, deren absolute Zahl über den gesamten Untersuchungszeitraum insgesamt konstant blieb, hat jedoch nach wie vor einen hohen Stellenwert bei der Behandlung von vorwiegend stromalen oder durchgreifenden Hornhautdefekten. Der Anteil HLA-kompatibler Keratoplastiken hat vermutlich insbesondere vor dem Hintergrund fehlender eindeutiger Nachweise einer Verringerung der Abstoßungsraten in Standardsituationen in den letzten Jahren weiter abgenommen.
journal_name
Klin Monbl Augenheilkdjournal_title
Klinische Monatsblatter fur Augenheilkundeauthors
Daniel MC,Böhringer D,Lapp T,Maier PC,Reinhard T,Lang SJdoi
10.1055/a-1035-9442subject
Has Abstractpub_date
2020-01-22 00:00:00eissn
0023-2165issn
1439-3999pub_type
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journal_title:Klinische Monatsblatter fur Augenheilkunde
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journal_title:Klinische Monatsblatter fur Augenheilkunde
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journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:
更新日期:1975-12-01 00:00:00
abstract::Four serologically-proved cases of intraocular toxocara infections are demonstrated. Three different manifestations in the following way were found: 1. Solitary granuloma on the posterior pole (2 patients). 2. Anterior and posterior uveitis of both eyes with granuloma near the ora (1 patient). 3. Iridocyclitis of both...
journal_title:Klinische Monatsblatter fur Augenheilkunde
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abstract::Six patients, members of a family with familial exudative vitreoretinopathy (FEVR), were studied to verify whether the disease was associated with a suspected platelet aggregation defect. No hemostaseologic defect was found in either the affected or healthy members of the family; in particular, there were no grounds f...
journal_title:Klinische Monatsblatter fur Augenheilkunde
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abstract:BACKGROUND:Sleepiness behind the wheel is the second most frequent cause of fatal highway accidents when trucks are involved. Spontaneous pupillary oscillations provide objective and quantitative measures of the tonic central nervous activation which is a precondition for higher level mental performance. First experien...
journal_title:Klinische Monatsblatter fur Augenheilkunde
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abstract:BACKGROUND:Tumor necrosis may reflect a destructive immune reaction. Systematic and statistically significant comparative clinico-histopathologic studies have not yet been reported. PATIENTS AND METHODS:113 necrotizing choroidal melanomas (NCM) recruited from 701 enucleated globes 1967-1988 were resectioned, stained a...
journal_title:Klinische Monatsblatter fur Augenheilkunde
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journal_title:Klinische Monatsblatter fur Augenheilkunde
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journal_title:Klinische Monatsblatter fur Augenheilkunde
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journal_title:Klinische Monatsblatter fur Augenheilkunde
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journal_title:Klinische Monatsblatter fur Augenheilkunde
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journal_title:Klinische Monatsblatter fur Augenheilkunde
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journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
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journal_title:Klinische Monatsblatter fur Augenheilkunde
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doi:
更新日期:1975-07-01 00:00:00
abstract:BACKGROUND:Sectorial visual field defects after macular hole surgery were described by several authors. The intraocular gas tamponade is discussed to be a possible causative factor for this complication. PATIENTS AND METHODS:Goldmann perimetry and threshold perimetry were performed preoperatively and 6 weeks postopera...
journal_title:Klinische Monatsblatter fur Augenheilkunde
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journal_title:Klinische Monatsblatter fur Augenheilkunde
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journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 临床试验,杂志文章
doi:
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journal_title:Klinische Monatsblatter fur Augenheilkunde
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journal_title:Klinische Monatsblatter fur Augenheilkunde
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journal_title:Klinische Monatsblatter fur Augenheilkunde
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journal_title:Klinische Monatsblatter fur Augenheilkunde
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journal_title:Klinische Monatsblatter fur Augenheilkunde
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abstract::On the occasion of the 150th aniversary of Albrecht von Graefe's birthday his short but successful activity for ophthalmology is brought back to mind. Within the scape of his life-history the attempt is made to portray a man in his time and to waken his importance as ophthalmologist a significant still in our days. ...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 传,历史文章,杂志文章
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更新日期:1978-05-01 00:00:00
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journal_title:Klinische Monatsblatter fur Augenheilkunde
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