Chronological Characteristic Analysis of Corneal Transplantations at a Single Tertiary Referral Hospital

Abstract

 

Purpose

 

To investigate the chronological changes of corneal transplantation in purposes, underlying causes, accompanying risk factors, surgical techniques, mean postoperative best corrected visual acuity and graft survival rate before and after the time-point (2004) of wide use of foreign imported corneas.

 

Methods

 

Consecutive medical records of 375 eyes underwent corneal transplantation between 2000 and 2012 at a single tertiary referral center were retrospectively reviewed and randomly selected. Main indications for corneal transplantations were classified into optical, therapeutic, and tectonic purposes and underlying causes were divided into 11 different corneal disease categories. Known 43 potential demographic, preoperative, intraoperative, and donor risk factors for graft rejection were collected. Surgical methods applied to each case were also reviewed.

 

Results

 

The overall graft survival rate of domestic and imported cornea were 44.2% and 63.8% respectively. In the order of frequency, main purposes were optical (93.9%), tectonic(2.4%), and therapeutic (2.4%) before 2004 compared with optical (90.8%), therapeutic (4.8%) and tectonic (4.4%) after 2004. Main diagnoses were postinfectious scarring (30.5%), regraft (17.1%), corneal opacity due to unknown cause (15.9%) before 2004 and were regraft (29.4%), corneal opacity due to unknown cause (18.4%), postinfectious scarring (15.0%) after 2004. The proportion of corneal neovascularization range wider than 1 quadrant was 48.8% before 2004 and 63.5% after 2004. The proportion of concurrent cataract surgery was 18.3% before 2004 and 25.6% after 2004. Mean postoperative best corrected logMAR visual acuity was 1.11 before 2004 and 0.80 after 2004.

 

Conclusions

 

Wide use of foreign imported cornea diversified indications for corneal transplantations, increased surgeries in patients with higher risks for rejection, and enabled more complicated surgical procedures.

 

Keywords: 741 transplantation