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Can J Ophthalmol. 2017 Feb;52(1):74-79. doi: 10.1016/j.jcjo.2016.07.005. Epub 2016 Sep 7.

Current indications and surgical approaches to corneal transplants at the University of Toronto: A clinical-pathological study.

Author information

1
Keenan Research Centre for Biomedical Science at the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ont.
2
Keenan Research Centre for Biomedical Science at the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ont; Ophthalmology & Vision Sciences, St. Michael's Hospital, University of Toronto, Toronto, Ont.
3
Keenan Research Centre for Biomedical Science at the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ont; Ophthalmology & Vision Sciences, St. Michael's Hospital, University of Toronto, Toronto, Ont; Laboratory Medicine & Pathobiology, St. Michael's Hospital, University of Toronto, Toronto, Ont; Ophthalmic Pathology Laboratory, University of Toronto, Toronto, Ont.
4
Keenan Research Centre for Biomedical Science at the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ont; Laboratory Medicine & Pathobiology, St. Michael's Hospital, University of Toronto, Toronto, Ont.
5
Keenan Research Centre for Biomedical Science at the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ont; Ophthalmology & Vision Sciences, St. Michael's Hospital, University of Toronto, Toronto, Ont; Laboratory Medicine & Pathobiology, St. Michael's Hospital, University of Toronto, Toronto, Ont. Electronic address: guptan@smh.ca.

Abstract

OBJECTIVE:

To determine the most common reasons and surgical approaches for corneal graft surgery at the Kensington Eye Institute (KEI), University of Toronto.

DESIGN:

Retrospective cross-sectional study.

PARTICIPANTS:

A total of 229 consecutive corneal transplants performed at the KEI.

METHODS:

Demographic, clinical, and pathological data on all 2012 and 2013 corneal transplants were collected.

RESULTS:

The mean age for corneal transplants was 65 ± 16 years; 39% were full-thickness penetrating keratoplasties (PK) and 61% were partial-thickness. Graft failure (30%), infection (18%), and keratoconus (17%) were the leading indications for PK. Fuchs' dystrophy (40%) and bullous keratopathy (24%) were main causes for partial-thickness procedures. Among partial-thickness approaches, Descemet's stripping automated endothelial keratoplasty (DSAEK), deep anterior lamellar keratoplasty (DALK), and Descemet's membrane endothelial keratoplasty (DMEK) procedures accounted for 68%, 16%, and 16%, respectively. Fuchs' dystrophy (40%) and bullous keratopathy (33%) were the most common indications for DSAEK. Keratoconus (57%) and corneal scarring (35%) were the most common indications for DALK, whereas Fuchs' dystrophy (82%) accounted for most DMEK procedures. The most common reasons for all corneal grafts were Fuchs' dystrophy (25%), bullous keratopathy (21%), graft failure (17%), and keratoconus (12%).

CONCLUSIONS:

Almost two-thirds of all corneal transplant procedures at the University of Toronto are partial thickness procedures. A failed graft was found to be the most common indication for full-thickness transplants. Fuchs' dystrophy was the most common indication for a partial-thickness approach, most often treated by DSAEK. Longitudinal data are needed to determine whether partial-thickness surgeries will improve graft survival and reduce the need for regraft.

PMID:
28237153
DOI:
10.1016/j.jcjo.2016.07.005
[Indexed for MEDLINE]
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