Canadian journal of ophthalmology. Journal canadien d'ophtalmologie · 2018
New trends in corneal transplants at the University of Toronto.
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Обработка статьи · этапы, ошибки и управление
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Chan Sze Wah Samuel, Yucel Yeni, Gupta Neeru
Аннотация
OBJECTIVE: To assess trends in surgical procedures and indications for all corneal transplants performed at the University of Toronto.
DESIGN: Retrospective cross-sectional study.
PARTICIPANTS: One thousand one hundred and four consecutive corneal transplants performed at the Kensington Eye Institute (KEI).
METHODS: Demographic, clinical, and pathological data retrieved from the Ophthalmic Pathology Laboratory on all corneal transplants performed at the KEI from January 2014 to December 2016.
RESULTS: Over 3 years, partial-thickness lamellar keratoplasties were performed in 880 cases (80%) while full-thickness penetrating keratoplasties (PKP) accounted for 224 cases (20%). Leading causes of corneal transplant were Fuchs' dystrophy (42%), graft failure (17%), bullous keratopathy (15%), and keratoconus (15%). Graft failure (40%) and keratoconus (31%) were the leading causes for PKP. Descemet's membrane endothelial keratoplasty (DMEK) accounted for 37% of cases, Descemet's stripping automated endothelial keratoplasty (DSAEK) for 30%, and deep anterior lamellar keratoplasty (DALK) for 13%. By 2016, partial-thickness procedures had increased by 10%, accounting for 85% of all procedures. In addition, DMEK increased by 26%, DSAEK decreased by 13%, and PKP decreased by 11%. Fuchs' dystrophy remained the leading indication for DMEK (67%) and DSAEK (42%) procedures. In 2016, 73% of DALK procedures were for the treatment of keratoconus.
CONCLUSIONS: Partial-thickness corneal transplants now account for 85% of all current graft procedures, and DMEK has emerged as the procedure of choice. Graft failure continues to be the leading indication for full-thickness grafts. Longitudinal studies are needed to determine whether these new trends persist and their future impact on graft failures.
DESIGN: Retrospective cross-sectional study.
PARTICIPANTS: One thousand one hundred and four consecutive corneal transplants performed at the Kensington Eye Institute (KEI).
METHODS: Demographic, clinical, and pathological data retrieved from the Ophthalmic Pathology Laboratory on all corneal transplants performed at the KEI from January 2014 to December 2016.
RESULTS: Over 3 years, partial-thickness lamellar keratoplasties were performed in 880 cases (80%) while full-thickness penetrating keratoplasties (PKP) accounted for 224 cases (20%). Leading causes of corneal transplant were Fuchs' dystrophy (42%), graft failure (17%), bullous keratopathy (15%), and keratoconus (15%). Graft failure (40%) and keratoconus (31%) were the leading causes for PKP. Descemet's membrane endothelial keratoplasty (DMEK) accounted for 37% of cases, Descemet's stripping automated endothelial keratoplasty (DSAEK) for 30%, and deep anterior lamellar keratoplasty (DALK) for 13%. By 2016, partial-thickness procedures had increased by 10%, accounting for 85% of all procedures. In addition, DMEK increased by 26%, DSAEK decreased by 13%, and PKP decreased by 11%. Fuchs' dystrophy remained the leading indication for DMEK (67%) and DSAEK (42%) procedures. In 2016, 73% of DALK procedures were for the treatment of keratoconus.
CONCLUSIONS: Partial-thickness corneal transplants now account for 85% of all current graft procedures, and DMEK has emerged as the procedure of choice. Graft failure continues to be the leading indication for full-thickness grafts. Longitudinal studies are needed to determine whether these new trends persist and their future impact on graft failures.