中文摘要：

目的探讨2004-2015年本院角膜移植手术适应证和术式的变化趋势。方法对2004年1月-2015年12月本院施行角膜移植手术的病例进行回顾性调查,分析患者的人口学资料、角膜移植手术适应证和术式的变化趋势。结果 2004-2015年共有患者631例,角膜移植手术721台。其中男性430例（68.15%）489眼,女性201例（31.85%）232眼。前4位角膜移植手术适应证依次为角膜白斑135例（18.72%）,再次手术（已实施1次及以上角膜移植手术患者因角膜原发病复发、植片排斥、植片溶解、人工角膜溶解等需再次手术）122例（16.92%）,化脓性角膜炎90例（12.48%）,圆锥角膜89例（12.34%）。化脓性角膜炎、再次手术和圆锥角膜逐年增多,2004年化脓性角膜炎、再次手术和圆锥角膜各3例、9例、3例,2015年分别为16例、15例、20例。在所有角膜移植手术中,穿透性角膜移植（penetrating keratoplasty,PKP）414例（57.42%）,深板层角膜移植（deep lamellar keratoplasty,DLKP）161例（22.33%）,板层角膜移植（lamellar keratoplasty,LKP）134例（18.59%）,角膜内皮移植（endothelia keratoplasty,EKP）12例（1.66%）。DLKP和LKP近5年明显增多,2010年DLKP 6例,LKP 8例,2015年DLKP 20例,LKP 18例。而PKP自2012年后有减少趋势,2012年PKP 60例,2015年仅34例。结论角膜白斑、再次手术、化脓性角膜炎、圆锥角膜是本院角膜移植手术适应证前4位。穿透性角膜移植术式逐渐减少,而深板层角膜移植术式增加。角膜内皮移植术开始逐渐应用于临床。

英文摘要：

Objective To report the evolving of the indications for keratoplasty and the shift of the type of keratoplasty performed in Chinese PLA General Hospital from 2004 to 2015. Methods A retrospective data review was carried out to all the records of keratoplasty in Chinese PLA General Hospital from January 2004 to December 2015, and patient＇s demographics, indications and types of transplantation performed were analyzed. Results Totally 721 keratoplasties were performed on 631 patients. Four hundred and thirty patients （68.15%） were male （489 eyes）, and 201 cases（31.85%） were female（232 eyes）. Keratoleukoma （135 cases, 18.72%）, regraft （122 cases,16.92%）, purulent keratitis （90 cases, 12.48%） and keratoconus （89 cases, 12.34%） were the leading indications for keratoplasty, and transplantations for purulent keratitis, regraft and keratoconus increased year by year. In 2004, keratoplasties were performed in 3 cases of purulent keratitis, 9 cases of regraft and 3 cases of keratoconus, and the frequencies reached to 16, 15 and 20 respectively in 2015. Of all keratoplasties performed, 414 （57.42%） were penetrating keratoplasty （PKP）, 161（22.33%） were deep lamellar keratoplasty （DLKP）, 134（18.59%） were lamellar keratoplasty（LKP）, and 12（1.66%） were endothelia keratoplasty （EKP）. DLKP （2010, n=6; 2015, n=20） and LKP （2010, n=8; 2015, n=18） increased in recent 5 years, while PKP had been decreasing since2012（2012, n=60; 2015, n=34）. Conclusion The keratoleukoma, regraft, purulent keratitis and keratoconus were the top 4 indications for keratoplasty. DLKP demonstrated an increasing trend while PKP showed a decrease. EKP has been applied in clinical practice.