Indications and techniques of corneal transplants performed in one center in Southern Poland, in the years 2001–2020

Abstract

Purpose The study aimed to evaluate changes over a period of time in techniques and indications for corneal transplantation in a single center in Poland. Methods Retrospective analysis of corneal transplants performed at the Ophthalmology Department of the District Railway Hospital in Katowice in 2001–2020. Data on indications and surgical technique were collected. Results A total of 3021 corneal transplantations were performed in the years 2000–2020. The most common technique was penetrating keratoplasty (69,54%), then lamellar grafts—both anterior and posterior (19,63%), and limbal grafts (10,82%). Only in 2007 the number of lamellar keratoplasties exceeded the number of penetrating grafts and accounted for 108 (54,55%), including 85 (42,93%) of Descemet Stripping Automated Endothelial Keratoplasty. The only noticeable trend in changing techniques was a decrease in the number of performed deep anterior lamellar keratoplasties (r 2 = -0.21) over the last seven years. Main indications included bullous keratopathy (23,22%), following keratoconus (18,59%), leukoma (14,67%), keratitis and perforation (14,3%), Fuchs dystrophy (11,4%), and regrafts (7,22%). Leukoma and bullous keratopathy as an indications for corneal transplant have been declining over the years (r2 = 0.60 and r2 = 0.30 respectively). Consecutively, indications such as fuchs dystrophy, regraft and keratitis perforation have increased (r2 = 0.05, r2 = 0.50, r2 = 0.33) Conclusions The number of keratoplasties gradually increased from 2001 to 2020. It could be possible that the development and spread of new therapeutic alternatives, like corneal cross-linking and scleral lenses, have contributed to the decrease in deep anterior lamellar keratoplasty performed. There was an increasing trend in the percentage of penetrating keratoplasties for failed grafts, Fuchs dystrophy and infectious keratitis.

Post-Keratoplasty Microbial Keratitis in the Era of Lamellar Transplants—A Comprehensive Review

“…The annual number of corneal transplants and the paradigm of corneal transplantation have changed significantly in recent years [6,7]. Over a decade ago, the number of endothelial keratoplasties (DSAEKs and DMEKs, Descemet's stripping automated endothelial keratoplasty and Descemet's membrane endothelial keratoplasty, accordingly) outnumbered the number of penetrating keratoplasties performed globally [8].…”