眼角膜病变1082眼的病理分类

Pathological classification of 1082 eyes with corneal disease

目的:探讨华西医院眼科角膜病变的手术指征以及角膜标本的病理类型。方法:回顾性分析1990-01/2009-12华西医院眼病理室收检的1082眼角膜病变标本的临床病理资料。结果:角膜标本1030例1082眼,21种病理类型,构成比由高到低依次为:角膜瘢痕340眼(31.42%),角膜炎157眼(14.51%),圆锥角膜134眼(12.38%),迷芽瘤133眼(12.29%),大泡性角膜病变61眼(5.64%),角膜瘢痕伴慢性炎症59眼(5.45%),角膜表面纤维组织增生、新生血管,伴或不伴炎细胞浸润43眼(3.97%),角膜变性28眼(2.59%),鳞状细胞癌23眼(2.13%),角膜营养不良21眼(1.94%),非典型增生18眼(1.66%),角膜穿孔15眼(1.39%),乳头状瘤11眼(1.02%),色素痣10眼(0.92%),假上皮瘤样增生7眼(0.65%),ICE综合征、原位癌、恶性黑色素瘤和上皮角化或角化不良各5眼(0.46%),钙化上皮瘤、淀粉样变性各1眼(0.09%)。2000/2009年较1990/1999年手术量大幅增加(912/170)。14岁以下儿童206例211眼,先天性迷芽瘤和角膜白斑是儿童进行角膜手术的主要原因,分别占44.55%和36.49%。结论:角膜斑痕、角膜炎、圆锥角膜和迷芽瘤是华西医院角膜移植手术的主要原因。

AIM： To evaluate the corneal surgical indications and histopathological classification of corneal specimens in West China Hospital. METHODS： Retrospective analysis was performed on 1082 eyes suffering from corneal disease diagnosed from January 1990 to December 2009 at pathological department in West China Hospital. RESULTS： A total of 1082 corneal specimens were identified, the constituent ratio of which was as follows： corneal scar 31.42%（340/1082）, keratitis 14.51%（157/1082）, keratoconus 12.38%（134/1082）, choristoma 1229%（133/1082）, bullous keratopathy 5.64%（61/1082）, corneal scar associated with keratitis 5.45%（59/1082）, epicorneal fibrotic proliferation and neovascularization with or without inflammatory cells infiltration 3.97%（43/1082）, corneal degeneration 2.59%（28/1082）, squamous cell carcinoma 2.13%（23/1082）, corneal dystrophy 194% （21/1082）, atypical hyperplasia 1.66%（18/1082）, corneal perforation 1.39%（15/1082）, papilloma 1.02%（11/1082）, nevus 0.92%（10/1082）, pseudo-epitheliomatous hyperplasia 0.65%（7/1082）, ICE syndrome 0.46%（5/1082）, intraepithelial epithelioma 0.46%（5/1082）, malignant melanoma 0.46%（5/1082）, keratinization or dyskeratosis 0.46%（5/1082）, calcifying epithelioma 009%（1/1082）, amyloid degeneration 0.09%（1/1082）. There was an obvious increase in the number of operation from 2000 to 2009 compared with that from 1990 to 1999（912/170）. 211 eyes was from childen, in which congenital choristoma and corneal scar accounted for 4455% and 36.49% respectively. CONCLUSION： The leading reasons for keratoplasty in West China Hospital are corneal scar, keratitis, keratoconus and choristoma.