The aim of this study was to report the 12-year longitudinal trends in indication and corneal transplantation techniques in France from 2004 to 2015.
Results:
The records of all corneal transplantations performed from 2004 to 2015 in France were retrospectively reviewed. The patient indications and types of transplant performed were analyzed. A total of 46,658 corneal transplantations were performed between 2004 and 2015, with 34,187 (73.3%) penetrating keratoplasty and 10,452 (22.4%) lamellar keratoplasty. The leading surgical indications were secondary endothelial failure (24.3%), keratoconus (18.8%), regraft (13.5%), and Fuchs endothelial corneal dystrophy (15.1%). Endothelial keratoplasty became the preferred technique for endothelial diseases and deep anterior lamellar keratoplasty the preferred technique for keratoconus, surpassing penetrating keratoplasty in 2013.
Conclusion:
Secondary endothelial failure is the top indication for performing a keratoplasty over the 12-year period. There was a shift from penetrating keratoplasty to endothelial keratoplasty performed for Fuchs endothelial corneal dystrophy and secondary endothelial failure, and to deep anterior lamellar keratoplasty, performed for keratoconus. This highlights an important shift in managing corneal diseases toward the application of selective and more conservative surgeries and changes in indications in corneal transplantation.
MellesGREgginkFALanderFet al. A surgical technique for posterior lamellar keratoplasty. Cornea1998; 17(6): 618–626.
2.
TerryMAOusleyPJ.Deep lamellar endothelial keratoplasty in the first United States patients: early clinical results. Cornea2001; 20(3): 239–243.
3.
ParkCYLeeJKGorePKet al. Keratoplasty in the United States: a 10-year review from 2005 through 2014. Ophthalmology2015; 122(12): 2432–2442.
4.
CunninghamWJBrookesNHTwohillHCet al. Trends in the distribution of donor corneal tissue and indications for corneal transplantation: the New Zealand National Eye Bank study 2000–2009. Clin Exp Ophthalmol2012; 40(2): 141–147.
5.
GalvisVTelloAGomezAJet al. Corneal transplantation at an ophthalmological referral center in Colombia: indications and techniques (2004–2011). Open Ophthalmol J2013; 7: 30–33.
6.
FrigoACFasoloACapuzzoCet al. Corneal transplantation activity over 7 years: changing trends for indications, patient demographics and surgical techniques from the corneal transplant epidemiological study (CORTES). Transplant Proc2015; 47(2): 528–535.
7.
ReinhartWJMuschDCJacobsDSet al. Deep anterior lamellar keratoplasty as an alternative to penetrating keratoplasty a report by the American academy of ophthalmology. Ophthalmology2011; 118(1): 209–218.
8.
TingDSSauCYSrinivasanSet al. Changing trends in keratoplasty in the West of Scotland: a 10-year review. Br J Ophthalmol2012; 96(3): 405–448.
9.
WangJHasenfusASchirraFet al. Changing indications for penetrating keratoplasty in homburg/Saar from 2001 to 2010–histopathology of 1,200 corneal buttons. Graefes Arch Clin Exp Ophthalmol2013; 251(3): 797–802.
10.
XieLQiFGaoHet al. Major shifts in corneal transplantation procedures in North China: 5316 eyes over 12 years. Br J Ophthalmol2009; 93(10): 1291–1295.
11.
AnshuAPriceMOPriceFWet al. Risk of corneal transplant rejection significantly reduced with Descemet’s membrane endothelial keratoplasty. Ophthalmology2012; 119(3): 536–540.
12.
GuilbertEBulletJSandaliOet al. Long-term rejection incidence and reversibility after penetrating and lamellar keratoplasty. Am J Ophthalmol2013; 155(3): 560–569.
13.
MaierAKGundlachEGonnermannJet al. Fellow eye comparison of descemet membrane endothelial keratoplasty and penetrating keratoplasty. Cornea2013; 32(10): 1344–1348.
14.
HeindlLMRissSBachmannBOet al. Split cornea transplantation for 2 recipients: a new strategy to reduce corneal tissue cost and shortage. Ophthalmology2011; 118(2): 294–301.
15.
LegeaisJMParcCd’HermiesFet al. Nineteen years of penetrating keratoplasty in the Hotel-Dieu Hospital in Paris. Cornea2001; 20(6): 603–606.
16.
PoinardCTuppinPLotyBet al. The French national waiting list for keratoplasty created in 1999: patient registration, indications, characteristics, and turnover. J Fr Ophtalmol2003; 26(9): 911–919.
17.
GhoshehFRCremonaFARapuanoCJet al. Trends in penetrating keratoplasty in the United States 1980–2005. Int Ophthalmol2008; 28(3): 147–153.
18.
LindquistTDMcGlothanJSRotkisWMet al. Indications for penetrating keratoplasty: 1980–1988. Cornea1991; 10(3): 210–216.
19.
BeekhuisWH.Current clinician’s opinions on risk factors in corneal grafting: results of a survey among surgeons in the eurotransplant area. Cornea1995; 14(1): 39–42.
20.
BorderieVMTouzeauOAllouchCet al. The results of successful penetrating keratoplasty using donor organ-cultured corneal tissue. Transplantation1999; 67(11): 1433–1448.
21.
ClaessonMArmitageWJFagerholmPet al. Visual outcome in corneal grafts: a preliminary analysis of the Swedish corneal transplant register. Br J Ophthalmol2002; 86(2): 174–180.
22.
HaamannPJensenOMSchmidtP.Changing indications for penetrating keratoplasty. Acta Ophthalmol1994; 72(4): 443–446.
23.
KonradssonAJonassonFHannessonOBet al. Penetrating keratoplasty in Iceland 1981–1996. Laeknabladid1998; 84(3): 194–200.
24.
LangGKWilkCMNaumannGO.Changes in the indications status for keratoplasty (Erlangen, 1964–1986). Fortschr Ophthalmol1988; 85(3): 255–258.
25.
MellesGR.Posterior lamellar keratoplasty: DLEK to DSEK to DMEK. Cornea2006; 25(8): 879–881.
26.
MuraineMToubeauDGueudryJet al. Impact of new lamellar techniques of keratoplasty on eye bank activity. Graefes Arch Clin Exp Ophthalmol2007; 245(1): 32–38.
27.
KimBZet al. New Zealand trends in corneal transplantation over the 25 years 1991–2015. Br J Ophthalmol2016. doi:10.1136/bjophthalmol-2016-309021
28.
TanJCHet al. Evolving indications for and trends in keratoplasty in British Columbia, Canada, from 2002 to 2011: a 10-year review. Cornea2014; 33: 252–256.
29.
RabinowitzYS.Ectasia after laser in situ keratomileusis. Curr Opin Ophthalmol2006; 17(5): 421–426.
WollensakGSpoerlESeilerT.Riboflavin/ultraviolet-a-induced collagen crosslinking for the treatment of keratoconus. Am J Ophthalmol2003; 135(5): 620–627.
32.
WangJYXieLXSongXSet al. Trends in the indications for penetrating keratoplasty in Shandong, 2005–2010. Int J Ophthalmol2011; 4(5): 492–497.
33.
KymionisGDKankariyaVPPlakaADet al. Femtosecond laser technology in corneal refractive surgery: a review. J Refract Surg2012; 28(12): 912–920.
34.
RandlemanJBTrattlerWBStultingRD.Validation of the Ectasia risk score system for preoperative laser in situ keratomileusis screening. Am J Ophthalmol2008; 145(5): 813–818.
35.
SanthiagoMRKara-JuniorNWaringGOIV. Microkeratome versus femtosecond flaps: accuracy and complications. Curr Opin Ophthalmol2014; 25(4): 270–274.
