Abstract
Purpose::
To identify and quantify the indications for emergency corneal grafting (eCG) in the United Kingdom (UK) and the Republic of Ireland (ROI) over a period from 1999 to 2005.
Methods::
Prospective, multifactorial analyses of all corneal grafts registered by the United Kingdom Transplant Service from April 1999 to March 2005. eCGs were classified by using ‘reasons for grafts’: therapeutic grafts (severe infection, threatened or actual perforation), as selected by corneal transplant surgeons on the United Kingdom Transplant Registration Form. Of these cases the underlying diagnostic condition was analysed.
Results::
In the study period a total of 12976 corneal grafts were performed of which 11646 (88.6%) were done under routine conditions and 1330 (11.4%) under emergency circumstances (including 433 regrafts). The main reason for an eCG was actual perforation in 876 (65.9%) patients. The main diagnostic categories for eCG were infection (353 patients, 39.4%) and ulcerative keratitis (289 patients, 32.2%). Other conditions such as ectasias (7%), previous ocular surgery (5.7%), ocular injury (4.1%), dystrophies (2.6%) and opacification (1.9%) were less frequent.
Conclusions::
The data in this study shows the largest cohort of emegency corneal grafts ever to be reported. Our findings show that a significant percentage of corneal grafting in the UK & ROI is performed under emergency conditions. Typically, the most frequent indication for eCG is treatment of a corneal perforation following infection.
Keywords: cornea: clinical science • transplantation • keratitis