Clinical analysis of keratoplasty in the Wenzhou area from 1999 to 2009

Abstract

Objective To analyze the indications for keratoplasty at Eye Hospital of Wenzhou Medical College, Zhejiang province, from September 1999 to December 2009 and the trend of surgical procedures. Methods The investigation involved an analysis of the indications for these patients, and age, gender, place of residence, diagnosis, surgical procedure, etc., were recorded. All the information was input into an Excel format for descriptive analysis. Results were illustrated with graphs and format. Results During the approximate ten-year span, patient age distribution was bimodal, the average age was 44.4 years with peaks in the 6th decade. There were more male than female patients. There was a higher percentage of male patients with bacterial keratitis and trauma than for women. Nearly two-thirds of the patients were from the Wenzhou area. There were 651 cases (727 eyes) underwent corneal surgery in our study. This included 439 cases (495 eyes) of penetrating keratoplasty, 103 cases (123 eyes) of deep lamellar keratoplasty, 62 cases (62 eyes) of lamellar keratoplasty, 40 cases (40 eyes) of keratoplasty combined with cataract surgery and 7 cases (7 eyes) with other types of keratoplasty. The leading indications for keratoplasty were infectious keratitis (168, 23.1%), including bacterial keratitis (86, 11.8%) and fungal keratitis (82, 11.3%). This was followed by herpes simplex keratitis (165, 22.7%) and corneal scarring (95, 13.1%), including congenital corneal scarring and scarring from infection, trauma (64, 8.8%), including chemical burn, thermal burn and explosion injury, keratoconus (58, 8.0%), bullous keratopathy (pseudophakic or aphakic) (57, 7.8%), corneal dermoid (including Goldenharr syndrome) (43, 5.9%), corneal dystrophy and degeneration (41, 5.6%) and regrafting (24, 3.3%). The number of penetrating keratoplasty cases has gradually declined since 2005 and lamellar and deep lamellar keratoplasty cases have shown a gradually increasing trend. Conclusion In our study, infectious keratitis was the leading indicator for keratoplasty at Wenzhou area. Herpes simplex keratitis was the leading indicator for a single disease. This was similar to northern China, but different from European and American countries. For patients with normal endothelial function, deep lamellar keratoplasty will gradually replace penetrating keratoplasty as the leading surgery. Key words: Corneal transplantation; Small-area analysis; Surgical procedure,operative; Data collection