Indications for Keratoplasty at 3 Academic Centers from 2002 to 2012

Hsu, Kimberly; Chang, Shu‐Kong; Edelstein, Sean; Hsu, Hui-Tsung; Harocopos, George J.

doi:10.1097/icl.0000000000000227

Cited by 17 publications

(7 citation statements)

References 19 publications

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“…A failed graft remains a leading indication for PKP in this study and in other studies. [12][13][14]16,28,29 With increasing endothelial keratoplasties, it remains to be seen whether DSAEK and DMEK failures will continue to rise in Canada, as has been observed in New Zealand. 11 Repeat grafts was a leading indication for PKPs in North America.…”

Section: Discussionmentioning

confidence: 99%

New trends in corneal transplants at the University of Toronto

Chan

Yücel

Gupta

2018

Canadian Journal of Ophthalmology

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To assess trends in surgical procedures and indications for all corneal transplants performed at the University of Toronto. Design: Retrospective cross-sectional study.Participants: One thousand one hundred and four consecutive corneal transplants performed at the Kensington Eye Institute (KEI). Methods: Demographic, clinical, and pathological data retrieved from the Ophthalmic Pathology Laboratory on all corneal transplants performed at the KEI from January 2014 to December 2016. Results: Over 3 years, partial-thickness lamellar keratoplasties were performed in 880 cases (80%) while full-thickness penetrating keratoplasties (PKP) accounted for 224 cases (20%). Leading causes of corneal transplant were Fuchs' dystrophy (42%), graft failure (17%), bullous keratopathy (15%), and keratoconus (15%). Graft failure (40%) and keratoconus (31%) were the leading causes for PKP. Descemet's membrane endothelial keratoplasty (DMEK) accounted for 37% of cases, Descemet's stripping automated endothelial keratoplasty (DSAEK) for 30%, and deep anterior lamellar keratoplasty (DALK) for 13%. By 2016, partialthickness procedures had increased by 10%, accounting for 85% of all procedures. In addition, DMEK increased by 26%, DSAEK decreased by 13%, and PKP decreased by 11%. Fuchs' dystrophy remained the leading indication for DMEK (67%) and DSAEK (42%) procedures. In 2016, 73% of DALK procedures were for the treatment of keratoconus. Conclusions: Partial-thickness corneal transplants now account for 85% of all current graft procedures, and DMEK has emerged as the procedure of choice. Graft failure continues to be the leading indication for full-thickness grafts. Longitudinal studies are needed to determine whether these new trends persist and their future impact on graft failures. Objectif : Évaluer les tendances en matière d'interventions chirurgicales et d'indications pour toutes les greffes de cornée réalisées à l'Université de Toronto. Nature : Étude transversale rétrospective. Participants : Mille cent quatre greffes de cornée consécutives réalisées au Kensington Eye Institute (KEI). Méthodes : Données démographiques, cliniques et anatomopathologiques obtenues auprès du laboratoire d'anatomopathologie ophtalmique pour toutes les greffes de cornée réalisées de janvier 2014 à décembre 2016 au KEI. Résultats : Sur une période de 3 ans, une kératoplastie lamellaire en épaisseur partielle a été réalisée dans 880 cas (80 %), tandis que 224 cas (20 %) ont subi une kératoplastie pénétrante (KP) pleine épaisseur. Les causes principales ayant mené à la greffe de cornée étaient la dystrophie de Fuchs (42 %), l'échec de greffe (17 %), la kératopathie bulleuse (15 %) et le kératocône (15 %). L'échec de greffe (40 %) et le kératocône (31 %) représentaient les indications principales de la KP. Dans 37 % des cas, on a eu recours à la kératoplastie endothéliale de la membrane de Descemet (DMEK, pour Descemet's membrane endothelial keratoplasty), dans 30 % des cas, à la kératoplastie endothéliale automatisée avec décapage de la Descemet (DSAEK, p...

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Section: Discussionmentioning

confidence: 99%

New trends in corneal transplants at the University of Toronto

Chan

Yücel

Gupta

2018

Canadian Journal of Ophthalmology

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“…Academic centers had more severe and complicated cases in comparison with other services. 69 Another limitation includes the lack of information regarding the exact pathologies grouped as others or nondescribed. In addition, we were unable to evaluate the number of combined CT surgeries with cataract, glaucoma, or retina procedures.…”

Section: Discussionmentioning

confidence: 99%

Trends in Corneal Transplantation in a Tertiary Hospital in Brazil

Moriyama

Forseto

Pereira

et al. 2021

Cornea

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Purpose:The purpose of this study was to analyze the evolving trends of surgical techniques and indications of corneal transplantation (CT) at a tertiary hospital in Brazil.Methods:The medical records of all patients who underwent CT at the Hospital Oftalmológico de Sorocaba (Sorocaba Eye Hospital) from the Banco de Olhos de Sorocaba (Sorocaba Eye Bank) group in Sorocaba, Brazil, from January 1, 2012, to December 31, 2019, were analyzed. Data regarding age, sex, transplant indication, and surgical technique were collected.Results:A total of 16,250 CTs were performed. There was a statistically significant decreasing trend of keratoconus-related CT (P < 0.0001), with rates dropping from 41.7% among all CTs in 2012 to 25.5% in 2019. Penetrating keratoplasty, anterior lamellar keratoplasty, and endothelial keratoplasty (EK) accounted for 59.3%, 27.1%, and 7.8% of the CTs performed in 2012 and 33.3%, 16.4%, and 39.9% in 2019, respectively. A statistically significant decreasing trend was observed for penetrating keratoplasty (P < 0.0001) and anterior lamellar keratoplasty (P < 0.0001), whereas EK showed a statistically significant increasing trend during the period (P < 0.0001). Among EKs, Descemet membrane EK increased statistically significantly from 12.8% in 2012 to 74.4% in 2019 (P < 0.0001).Conclusions:This study shows relevant evolving trends in indications and preferred CT techniques in a tertiary hospital in Brazil.

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“…A 10-year study from 2004 at Queen Victoria Hospital in the UK found graft failure to be the leading indication for penetrating keratoplasty 10. Another study, examining statistics from 2002 to 2012, found graft failure to be the most prevalent indication for penetrating keratoplasty at the University of Washington and University of California, Davis in the USA 11. A recent 25-year study, by the University of Auckland, New Zealand, found graft failure to be the second most common indication for any type of corneal transplant 12.…”

Section: Introductionmentioning

confidence: 99%

Lymphatic vessels identified in failed corneal transplants with neovascularisation

et al. 2018

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BackgroundCorneal transplant failure with neovascularisation is a leading indication for full-thickness grafts in patients. Lymphangiogenesis is implicated in the pathology of graft failure, and here we systematically evaluate failed human corneal transplants with neovascularisation for the presence of lymphatic vessels.MethodsNine failed grafts with neovascularisation, based on H&E staining with subsequent immunoperoxidase staining for CD31, a blood vessel marker, were selected. Lymphatics were investigated by immunohistochemical and immunofluorescence approaches using podoplanin as a lymphatic marker. In two of nine cases, fluorescence in situ hybridisation (FISH) was used for detection of lymphatic mRNAs including podoplanin, VEGFR-3 and LYVE-1. All immunofluorescence and FISH samples were compared with positive and negative controls and visualised by confocal microscopy.ResultsCorneal neovascularisation was established in all cases by H&E and further confirmed by CD31 immunoreactive profiles. Immunohistochemistry for the podoplanin antibody was positive in all cases and showed morphologies ranging from distinct luminal structures to elongated profiles. Simultaneous immunofluorescence using CD31 and podoplanin showed lymphatic vessels distinct from blood vessels. Podoplanin immunofluorescence was noted in seven of nine cases and revealed clear lumina of varying sizes, in addition to lumen-like and elongated profiles. The presence of lymphatic mRNA was confirmed by FISH studies using a combination of at least two of podoplanin, VEGFR-3 and LYVE-1 mRNAs.ConclusionsThe consistent finding of lymphatic vessels in failed grafts with neovascularisation implicates them in the pathogenesis of corneal transplant failure, and points to the lymphatics as a potential new therapeutic target.

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Indications for Keratoplasty at 3 Academic Centers from 2002 to 2012

Cited by 17 publications

References 19 publications

New trends in corneal transplants at the University of Toronto

New trends in corneal transplants at the University of Toronto

Trends in Corneal Transplantation in a Tertiary Hospital in Brazil

Lymphatic vessels identified in failed corneal transplants with neovascularisation

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