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角膜移植策略用于阿坎萨摩巴角膜炎:系统性审查和元分析

Shangyang Jiang¹, Leying Wang¹, Zijun Zhang¹

¹Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China.

Journal of infection and public health

|December 24, 2025

概括

阿坎萨摩巴角膜炎 (AK) 的手术治疗方法各不相同. 当感染得到控制时,光学透角膜整形 (OPK) 产生最佳结果. 治疗性深前层层层层角塑造术 (TDALK) 对于前层层层感染是有效的,而治疗性穿透性角塑造术 (TPK) 则用于严重的病例.

科学领域:

眼科医生眼科眼科
传染性疾病传染性疾病
角膜外科手术角膜外科手术

背景情况:

阿坎萨摩巴角膜炎 (Acanthamoeba keratitis,简称AK) 是一种严重的,威胁视力的角膜感染.
缺乏外科管理的共识使得AK的临床决策变得复杂.
角膜整形手术是严重AK的关键手术干预.

研究的目的:

审查和比较不同角塑技术对AK的结果.
根据感染程度和控制来确定最佳的外科手术策略.

主要方法:

在PubMed,EMBASE,Web of Science和Cochrane图书馆的综合文献综述,截至2025年7月1日.
分析了包括487只眼睛在内的24项研究.
治疗性穿透式角质整形 (TPK),光学穿透式角质整形 (OPK) 和治疗性深前层层层角质整形 (TDALK) 的比较.

主要成果:

当Acanthamoeba感染得到充分控制时,光学透角膜整形术 (OPK) 显示出最有利的结果.
治疗性深前层层层层角塑造术 (TDALK) 显示了较高的移植存活率和较少的前层层层感染并发症.
对于全厚度感染,需要进行治疗性穿透性角膜整形 (TPK),这与视力恢复较差和移植失败率较高有关.

结论:

针对AK的外科手术策略应根据感染的程度和控制量身定制.
与TPK相比,OPK和TDALK在特定的AK场景中提供了更好的结果.
需要进一步就手术管理达成共识,以优化AK治疗.

关键词:

阿坎萨摩巴菌的角质炎.这是一个元分析.光学透式膜塑料.治疗性深层前层层层叶片角质塑造.治疗性透性角质塑料.

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