Patterns of Corneal Disorders in Corneal Button Specimens: Descriptive Study in a Tertiary Referral Hospital in Bahrain

Abstract

Introduction: Corneal injuries and disorders are among the commonest clinical scenarios that are encountered in the ophthalmology clinical practice. Penetrating Keratoplasty (PKP) surgeries count for the most frequent efficient surgical management of diseased corneas. The latter are usually sent as button specimens for histopathology examination for further describing the pattern of the corneal disorders. Aims and Objectives: The aims of this study are to discuss the rate of Penetrating Keratoplasty (PKP) surgeries in SMC in 6 years interval (2016-2022) along with to determine the most common histopathological and microbiological diagnosis of corneal specimens from Penetrating Keratoplasty (PKP) and to study the clinical spectrum with age and sex distribution of corneal disorders in Bahrain alongside correlation with the comorbidities and the pathological diagnosis. Patients and Methods: It is a retrospective analysis of one-hundred and one histopathology reports of corneal button specimens at Salmaniya medical complex during the last 6 years (1-1-2016 till 31-3-2022). Medical records, surgical notes and histopathology reports of patients were retrieved from ISEHA system. Statistical analysis was done using Microsoft Excel 2019. Results: Corneal scarring (44%) was the most common pathological diagnosis, followed by Keratoconus (KC) (15%), acute keratitis (14%), degeneration (9%), chronic keratitis with fibrosis (5%), decompensated cornea and failed graft (5%), pseudophakic bullous keratopathy (3%) and herpetic keratitis (3%). There was Bahraini nationality (98%) and male preponderance (66%). The most common age group affected was 70–79 years with the median age of 51.5 year. Conclusion: Our study shows the importance of determining the most common histological diagnoses of corneal button specimens along with the correlation of the latter with the age, gender, surgical complications and systemic comorbidities. Knowing the exact pathology of the diseased cornea would assist in providing the proper post-operative management and to avoid possible elements that could promote complications.