Abstract
PurposeTo report corneal transplant activity carried out in Catalonia (Spain) and the evolving indications for keratoplasty over an 8-year period.MethodsAnnual reports from the Catalan Transplant Organization, Spain, on corneal graft indications and techniques from 2011 to 2018 were reviewed.ResultsA total of 9457 keratoplasties were performed in Catalonia, from January 2011 to December 2018. The most frequent indications were bullous keratopathy (BK; 20.5%), Fuchs endothelial dystrophy (FED; 17.9%), re-graft (13.7%), and keratoconus (11.3%). Penetrating keratoplasty (PKP) accounted for 63.4% of all performed keratoplasties. Since the introduction of eye bank precut tissue for Descemet stripping automated endothelial keratoplasty (DSAEK) in 2013 and for Descemet membrane endothelial keratoplasty (DMEK) in 2017 the number of endothelial keratoplasties has drastically increased. An increasing trend of posterior lamellar techniques over the total of keratoplasties was found (p<0.001). Endothelial keratoplasties for different endothelial diseases indications (BK, FED, and re-graft), also showed and increasing trend (p<0.001). DMEK is the technique with the highest increase (statistically significantly different from linearity) over other endothelial keratoplasties in FED (p<0.001) but not in BK (p = 0.67) or re-grafts (p = 0.067).ConclusionEndothelial diseases represented the top indication for keratoplasty over the 8-year period. PKP is still the most used technique in Catalonia, but endothelial keratoplasties and especially DMEK showed a significant increasing trend over the last years. This is congruent with the main rationale nowadays for keratoplasties: to customize and transplant as less tissue as possible. Therefore, the availability of precut tissue could have definitely enforced such approach.
Highlights
Corneal grafts are one of the most frequent transplanted tissues in the world [1]
A total of 9457 keratoplasties were performed in Catalonia, from January 2011 to December 2018
Descemet membrane endothelial keratoplasty (DMEK) is the technique with the highest increase over other endothelial keratoplasties in Fuchs endothelial dystrophy (FED) (p
Summary
Keratoplasty techniques, and indications, have majorly changed these last years, thanks to the upraise of selective corneal surgeries that have vastly improved visual recovery results. Epidemiology on such surgeries is not always easy and mostly depends on regional eye bank report services. Keratoplasty indications, techniques and trends have not been studied in depth since the introduction of precut corneal tissue supply by the main regional eye bank in such a population with a high volume of transplantations, 1000 keratoplasties/year on average, representing 25% to 30% of total keratoplasties in Spain. Over the last few years, the number of keratoplasties has increased in Spain
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