Abstract
Purpose:To report changing trends in indications and techniques of corneal transplantation in Iran.Methods:We reviewed eye bank records of 47,129 patients who had undergone corneal transplantation between 2006 and 2013 at different eye centers throughout Iran.Results:The most common indication for corneal transplantation was keratoconus (KCN, n = 21,350 eyes, 45.3%), followed by bullous keratopathy (BK, n = 8,566 eyes, 18.2%), corneal opacity and scar (COS, n = 7,158 eyes, 15.2%), graft failure (n = 3,252 eyes, 6.9%), corneal dystrophies (n = 2,553 eyes, 5.4%), and infectious keratitis (n = 2,238 eyes, 4.7%). Over the study period, there was a significant increase in the frequency of BK (P = 0.001) and graft failure (P = 0.025), and a significant decrease in the relative frequency of COS (P = 0.012). The prevalence of KCN (P = 0.172), infectious keratitis (P = 0.107), and corneal dystrophies (P = 0.836) remained unchanged. The most common technique of corneal transplantation was penetrating keratoplasty (PKP, n = 33,476 eyes, 71.0%), followed by deep anterior lamellar keratoplasty (DALK, n = 8,363 eyes, 17.7%), Descemet's stripping automated endothelial keratoplasty (DSAEK, n = 3,516 eyes, 7.5%), tectonic (n = 1752, 3.7%), and keratolimbal allograft (KLAL, n = 19 eyes, 0.1%). Regarding the shift in surgical techniques, a significant increase was observed in DSAEK (P < 0.001), whereas PKP was significantly decreased (P = 0.005) over the 8-year period. No significant change was seen in the rates of DALK (P = 0.354), tectonic graft (P > 0.999) and KLAL (P = 0.151).Conclusion:KCN was the most common indication and PKP was the most prevalent technique used for corneal transplantation. Significant changes in surgical techniques were observed over the past 8 years; DSAEK demonstrated an increasing trend while PKP showed a decrease.
Highlights
Corneal disorders are the second leading cause of blindness in developing countries and it has been estimated that 23 million people suffer from unilateral corneal blindness worldwide.[1]
A study by Zare et al[14] revealed that bullous keratopathy (BK) and graft failure ranked as the second and third most common indications for corneal transplantation at a tertiary referral eye center in Tehran, Iran, over a 6‐year period
Macular corneal dystrophy was the most common corneal dystrophy leading to keratoplasty (52.0%) followed by Fuchs’ endothelial dystrophy (23.4%), and congenital hereditary endothelial dystrophy (9.0%)
Summary
Corneal disorders are the second leading cause of blindness in developing countries and it has been estimated that 23 million people suffer from unilateral corneal blindness worldwide.[1] The epidemiology of. A study by Zare et al[14] revealed that BK and graft failure ranked as the second and third most common indications for corneal transplantation at a tertiary referral eye center in Tehran, Iran, over a 6‐year period
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