Abstract
Purpose:The study aimed to review the indications and techniques for corneal transplantation at a tertiary referral center over a 5-year period.Methods:Records of patients who underwent corneal transplantation at Khalili Medical Center, Shiraz, Iran from September, 2012 to September, 2017 were reviewed.Results:A total of 1149 eyes of 956 patients underwent corneal transplantation. The most common indication was infectious corneal ulcers (n = 296, 25.8%), followed by keratoconus (n = 243, 21.1%), bullous keratopathy (n = 219, 19.1%), failed grafts (n = 117, 10.2%), non-herpetic corneal scars (n = 113, 9.8%), corneal stromal dystrophies (n = 33, 2.9%), pellucid marginal degeneration (n = 31, 2.7%), and trauma (n = 26, 2.3%); other indications included thin descemetocele, post-herpetic corneal scar, endothelial corneal dystrophies, anterior segment dysgenesis, corneal ectasia after laser in situ keratomileusis, and corneal fibrosis. Corneal transplantation techniques included penetrating keratoplasty (PKP, n = 789, 68.7%), deep anterior lamellar keratoplasty (DALK, n = 187, 16.3%), Descemet's stripping automated endothelial keratoplasty (n = 171, 14.9%), and keratolimbal allograft (n = 2, 0.1%) in descending order. In children (aged ≤18 years), the most common indication was keratoconus (n = 32, 41.6%), and the most common technique was PKP (n = 50, 64.9%). In patients aged 19-27 years, the most common indication was keratoconus (n = 89, 64.5%), and the most common technique was PKP (n = 75, 54.4%).Conclusion:Infectious corneal ulcer was the most common indication, and PKP was the most prevalent technique in patients undergoing corneal transplantation. DALK was an emerging alternative surgical treatment in patients with corneal disorders in which corneal endothelium is spared.
Highlights
Bullous keratopathy is reported to be the most common indication for corneal transplantation in developed countries,[2,3,4,5,6,7] and infectious corneal diseases and corneal scars are more prevalent in developing countries.[8,9,10]
We reviewed the indications and techniques of corneal transplantation performed over a 5‐year period at Khalili Medical Eye Center, a tertiary training and referral eye center in Shiraz, Iran
Corneal opacification referred to non‐herpetic corneal scar in the absence of active bacterial or viral infection; whereas, old corneal scars with confirmed diagnosis of herpes simplex keratitis based on the history and characteristic clinical features were reported separately
Summary
Corneal blindness due to infection, ectasia, corneal dystrophy, or other pathology is a major health problem. Indications for Corneal Transplantation; Jamali and Gholampour worldwide.[1] Indications for corneal transplantation have changed overtime and differ based on location such as the city and country; allocation of resources is based on the epidemiology of corneal pathologies in each region. Bullous keratopathy is reported to be the most common indication for corneal transplantation in developed countries,[2,3,4,5,6,7] and infectious corneal diseases and corneal scars are more prevalent in developing countries.[8,9,10] Certain indications for penetrating keratoplasty have changed over time in Iran.[11]
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