Trends in Corneal Transplantation and Characteristics of Donors in the Chongqing Eye Bank, China: A Retrospective Study, 1999–2018

Abstract

Aim: This study aimed to analyze corneal transplantation trends and voluntary donor characteristics at the Chongqing Eye Bank in China.Methods: We retrospectively reviewed and analyzed data from January 1, 1999, to December 31, 2018, covering 5,397 preregistered voluntary donors, 1,955 actual donors, 3,910 donated tissues, and 2,374 corneal transplantations.Results: The 5,397 preregistered donors included 13 ethnic groups, with an overall mean age of 39.6 years (SD 21.5) and 3,010 were women (55.8%). The most prevalent education level was college and above (2,546, 47.2%), and the most common ethnic group was Han (5,335, 98.85%). Of the 1,955 actual donors, the male-to-female ratio was 3.3, and the mean age was 57.1 (SD 23.0 years). Based on population size in 2018, Jiangbei county was the most active in donation willingness, with ~60 × 10−6 per capita, and the Yuzhong county was the most active in cornea donations, with ~451 × 0−6 per capita. Of the 3,910 donated corneas, 2,540 (65.0%) were clinically used. Of those not used, 978 (71.4%) were rejected for poor corneal quality. The 2,374 (93.5%) corneal transplantation procedures were done at the Department of Ophthalmology of the First Affiliated Hospital of Chongqing Medical University and the rest (n = 166, 6.5%) were performed in other centers. Of those 2,374 corneal transplantations, there were 1,671 penetrating keratoplasty (70.39%), 700 anterior lamellar keratoplasty (29.49%), and three corneal endothelial transplantations in our center (0.13%). The number of annual corneal transplantations increased by nearly 10 times, from 35 cases in 1999 to 327 cases in 2018. Among them, cases of penetrating keratoplasty and anterior lamellar keratoplasty increased from 27, and eight cases in 1999 to 230 and 94 cases in 2018, respectively. Infectious keratitis (37.0%) was the leading indication for keratoplasty, followed by corneal scar (19.8%). Over the study period, corneal scars dropped from the first (41.1% in 1999–2003) to the second indication (20.5% in 2014–2018), while infectious keratitis advanced to take the lead, ranging from 12.2% in 1999–2003 to 26.3% in 2014–2018.Conclusion: Our study reports corneal donation and transplantation trends in Chongqing over 20 years, showing that infectious keratitis is a leading indication for keratoplasty and that penetrating keratoplasty and anterior lamellar keratoplasty show upward trends. The analysis further suggests that a potential preregistered cornea donor is a female Han, with a higher education level.

Corneal blindness and eye banking: Current strategies and best practices

“…[ 11 ] In China, infectious keratitis (61.7%) accounts for the leading cause of CB. [ 12 ] The prevalence of CB in Western provinces is high compared with central and eastern provinces and ranges from 0.949% to 0.106%. [ 12 ] Infectious keratitis is a silent epidemic responsible for the primary cause of preventable blindness in developing countries and mainly affects low- and middle-income countries.…”

“…[ 12 ] The prevalence of CB in Western provinces is high compared with central and eastern provinces and ranges from 0.949% to 0.106%. [ 12 ] Infectious keratitis is a silent epidemic responsible for the primary cause of preventable blindness in developing countries and mainly affects low- and middle-income countries. [ 8 ] Worldwide prevention of infectious keratitis would reduce the significant impact of CB.…”

“…[ 28 ] Tan H et al . [ 12 ] analyzed the CT and donor characteristic trends in China EB from 1999 to 2018. About 3,910 corneas were received in Chongqing EB, China, and 65% were utilized for CT. Preregistered donors’ ages varied from 30 to 39 years from 1999 to 2003 to 60–69 years from 2014 to 2018.…”

Combined versus sequential penetrating keratoplasty and cataract surgery for herpes simplex keratitis: a retrospective study

“…Herpes simplex keratitis (HSK) is a leading cause of corneal blindness across the world (6,7). Particularly in developing countries, the incidence of HSK has become much greater (8).…”

Repeat corneal transplantation in Southern China: Indications, surgical technique, outcomes, and risk factors for repeat keratoplasty failure

“…Corneal blindness can cause reversible blindness and can be managed by healthy donor cornea transplantation. With the use of keratoplasty and increasing life expectancy, regrafting is now a common indication for keratoplasty in developed countries[ 1 2 3 ] and has been on the rise in developing countries[ 4 5 ] in recent decades. Repeat keratoplasty is technically more challenging and has lower graft survival rates than initial keratoplasty procedures, with graft survival rates ranging from 28% to 81% after repeat corneal transplantation.…”