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Hansen LO, Garcia R, Cresta FB, Torricelli AAM, Bechara SJ. Pediatric keratoconus epidemiology: a systematic scoping review. Int Ophthalmol 2024; 44:69. [PMID: 38347389 DOI: 10.1007/s10792-024-03010-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 10/29/2023] [Indexed: 02/15/2024]
Abstract
BACKGROUND Pediatric keratoconus (pediatric KC) causes progressive deformation of the cornea in children and adolescents, leading to a gradual loss of vision and a need for rehabilitation. However, new treatments may halt the disease and prevent worse outcomes that require penetrating keratoplasty and its associated morbidity and high cost, irreversible loss of vision, and amblyopia. Few systematic reviews focus on keratoconus-and even fewer, on pediatric KC. METHODS Here, we report a systematic scoping review of pediatric KC epidemiology and discuss the studies reporting data on pediatric KC. We used PRISMA-ScR methodology and checklists in the elaboration of the manuscript. The inclusion criteria were: English language; publication between August 7, 1998, and August 7, 2019 (20 years); theme of the study pediatric KC epidemiology. The search strategy: searches of the PubMed-MEDLINE database and Cochrane Database of Systematic Reviews, using eight combinations of the following MeSH terms: keratoconus; child; incidence; prevalence; pediatrics; adolescent; epidemiology. RESULTS We charted and reviewed the selected articles. Initial searches included 1802 records; after the exclusion of article duplicates, we screened 777 records, read 97 articles in full text, and included 76 articles in this review. CONCLUSIONS Recent epidemiological studies with better methodologies demonstrated increased prevalence rates in comparison to the older literature. This effect may be due to better diagnostic methods and better sample selection than those in historical studies. Diagnosis remains a major challenge as the early disease is usually asymptomatic. Economic and social aspects of pediatric KC remain understudied in the pediatric literature. Global, inclusive, and proactive screening studies in schools are imperative to better understand the great impact of this disease in the young.
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Affiliation(s)
- Lucca Ortolan Hansen
- Division of Ophthalmology, University of São Paulo School of Medicine, Rua Campos Bicudo, Number 73, apt 11 - A. Itaim Bibi, São Paulo, 04536-010, Brazil, Sao Paulo.
| | - Renato Garcia
- Division of Ophthalmology, University of São Paulo School of Medicine, Rua Campos Bicudo, Number 73, apt 11 - A. Itaim Bibi, São Paulo, 04536-010, Brazil, Sao Paulo
| | - Fernando Betty Cresta
- Division of Ophthalmology, University of São Paulo School of Medicine, Rua Campos Bicudo, Number 73, apt 11 - A. Itaim Bibi, São Paulo, 04536-010, Brazil, Sao Paulo
| | - André Augusto Miranda Torricelli
- Division of Ophthalmology, University of São Paulo School of Medicine, Rua Campos Bicudo, Number 73, apt 11 - A. Itaim Bibi, São Paulo, 04536-010, Brazil, Sao Paulo
| | - Samir Jacob Bechara
- Division of Ophthalmology, University of São Paulo School of Medicine, Rua Campos Bicudo, Number 73, apt 11 - A. Itaim Bibi, São Paulo, 04536-010, Brazil, Sao Paulo
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Qureshi S, Dohlman TH. Penetrating Keratoplasty: Indications and Graft Survival by Geographic Region. Semin Ophthalmol 2023; 38:31-43. [PMID: 36527378 PMCID: PMC10084850 DOI: 10.1080/08820538.2022.2152710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 12/23/2022]
Abstract
Corneal transplantation, or penetrating keratoplasty (PK), is the most common form of solid-organ transplantation performed worldwide. Here, we evaluated the indications for PK and rates of transplant survival around the world by geographic region. We conducted a literature search of PubMed, MEDLINE, and Google Scholar databases and identified 155 relevant studies from 41 countries published between 1987 and 2021. The most common indications for PK were keratoconus in Europe, Africa, the Middle East, Australia, New Zealand, and Central and South America, bullous keratopathy in North America, and corneal scarring in Asia. The overall global mean graft survival rates at 1-, 2-, 3-, 5-, and 10-years were 88.6%, 81.2%, 78.9%, 72.8%, and 61.2%, respectively. Through this systematic analysis of PK by region, we hope to bring a new perspective to the corneal transplantation literature and to potentially highlight global differences and unmet needs in patient care.
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Affiliation(s)
- Sana Qureshi
- Cornea Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Thomas H Dohlman
- Cornea Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
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Tan H, Lin M, Gou Q, Li A, Gu F, Liu Q, Zhang Q, Xu M, Kijlstra A, Yang P, Li H. Trends in Corneal Transplantation and Characteristics of Donors in the Chongqing Eye Bank, China: A Retrospective Study, 1999-2018. Front Med (Lausanne) 2021; 8:750898. [PMID: 34778313 PMCID: PMC8584146 DOI: 10.3389/fmed.2021.750898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 09/27/2021] [Indexed: 11/13/2022] Open
Abstract
Aim: This study aimed to analyze corneal transplantation trends and voluntary donor characteristics at the Chongqing Eye Bank in China. Methods: We retrospectively reviewed and analyzed data from January 1, 1999, to December 31, 2018, covering 5,397 preregistered voluntary donors, 1,955 actual donors, 3,910 donated tissues, and 2,374 corneal transplantations. Results: The 5,397 preregistered donors included 13 ethnic groups, with an overall mean age of 39.6 years (SD 21.5) and 3,010 were women (55.8%). The most prevalent education level was college and above (2,546, 47.2%), and the most common ethnic group was Han (5,335, 98.85%). Of the 1,955 actual donors, the male-to-female ratio was 3.3, and the mean age was 57.1 (SD 23.0 years). Based on population size in 2018, Jiangbei county was the most active in donation willingness, with ~60 × 10−6 per capita, and the Yuzhong county was the most active in cornea donations, with ~451 × 0−6 per capita. Of the 3,910 donated corneas, 2,540 (65.0%) were clinically used. Of those not used, 978 (71.4%) were rejected for poor corneal quality. The 2,374 (93.5%) corneal transplantation procedures were done at the Department of Ophthalmology of the First Affiliated Hospital of Chongqing Medical University and the rest (n = 166, 6.5%) were performed in other centers. Of those 2,374 corneal transplantations, there were 1,671 penetrating keratoplasty (70.39%), 700 anterior lamellar keratoplasty (29.49%), and three corneal endothelial transplantations in our center (0.13%). The number of annual corneal transplantations increased by nearly 10 times, from 35 cases in 1999 to 327 cases in 2018. Among them, cases of penetrating keratoplasty and anterior lamellar keratoplasty increased from 27, and eight cases in 1999 to 230 and 94 cases in 2018, respectively. Infectious keratitis (37.0%) was the leading indication for keratoplasty, followed by corneal scar (19.8%). Over the study period, corneal scars dropped from the first (41.1% in 1999–2003) to the second indication (20.5% in 2014–2018), while infectious keratitis advanced to take the lead, ranging from 12.2% in 1999–2003 to 26.3% in 2014–2018. Conclusion: Our study reports corneal donation and transplantation trends in Chongqing over 20 years, showing that infectious keratitis is a leading indication for keratoplasty and that penetrating keratoplasty and anterior lamellar keratoplasty show upward trends. The analysis further suggests that a potential preregistered cornea donor is a female Han, with a higher education level.
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Affiliation(s)
- Handan Tan
- Chongqing Key Lab of Ophthalmology, Chongqing Branch of National Clinical Research Center for Ocular Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing Eye Institute, Chongqing, China
| | - Meng Lin
- Chongqing Key Lab of Ophthalmology, Chongqing Branch of National Clinical Research Center for Ocular Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing Eye Institute, Chongqing, China
| | - Qingqing Gou
- Chongqing Key Lab of Ophthalmology, Chongqing Branch of National Clinical Research Center for Ocular Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing Eye Institute, Chongqing, China
| | - Aijia Li
- Chongqing Key Lab of Ophthalmology, Chongqing Branch of National Clinical Research Center for Ocular Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing Eye Institute, Chongqing, China
| | - Fengjuan Gu
- Chongqing Key Lab of Ophthalmology, Chongqing Branch of National Clinical Research Center for Ocular Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing Eye Institute, Chongqing, China
| | - Quan Liu
- Chongqing Key Lab of Ophthalmology, Chongqing Branch of National Clinical Research Center for Ocular Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing Eye Institute, Chongqing, China
| | - Qi Zhang
- Chongqing Key Lab of Ophthalmology, Chongqing Branch of National Clinical Research Center for Ocular Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing Eye Institute, Chongqing, China
| | - Mei Xu
- Chongqing Key Lab of Ophthalmology, Chongqing Branch of National Clinical Research Center for Ocular Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing Eye Institute, Chongqing, China
| | - Aize Kijlstra
- University Eye Clinic Maastricht, Maastricht, Netherlands
| | - Peizeng Yang
- Chongqing Key Lab of Ophthalmology, Chongqing Branch of National Clinical Research Center for Ocular Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing Eye Institute, Chongqing, China
| | - Hong Li
- Chongqing Key Lab of Ophthalmology, Chongqing Branch of National Clinical Research Center for Ocular Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing Eye Institute, Chongqing, China
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Wan X, Yao W, Zhao S, Xu J, Le Q. Indications and Surgical Techniques for Repeat Corneal Transplantation in Eastern China: A Twelve-Year Study. J Ophthalmol 2021; 2021:5514004. [PMID: 34631163 DOI: 10.1155/2021/5514004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 08/30/2021] [Indexed: 11/17/2022] Open
Abstract
Purpose To analyze the indications and surgical procedures for repeat keratoplasty in eastern China from 2008 to 2019. Methods This retrospective descriptive study included 418 eyes of 411 patients who underwent no less than 2 keratoplasties at the Eye, Ear, Nose and Throat Hospital of Fudan University from 2008 to 2019. Medical charts were reviewed. The primary indications for repeat keratoplasty, the reasons for regrafting, and the surgical techniques used in the treatment were collected and analyzed. Results Among 418 eyes, 337 eyes (80.6%) had one repeat keratoplasty, and 81 eyes (19.4%) had multiple repeat keratoplasties (≥2 repeat keratoplasties). The median interval between the initial keratoplasty and the first repeat keratoplasty was 25 months, and that between two keratoplasties after the first repeat keratoplasty was 27.5 months. Infectious keratitis was the leading primary indication for single repeat keratoplasty (80 cases, 23.7%) and multiple repeat keratoplasties (19 cases, 23.5%). The second most common primary indication was bullous keratopathy for single repeat keratoplasty (49 eyes, 14.5%) and chemical injury for multiple repeat keratoplasties (14 eyes, 17.3%). The main reason for regrafting was allograft rejection (262 cases, 49.3%), followed by endothelial dysfunction (92 cases, 17.3%), and for vision improvement after tectonic keratoplasty (60 cases, 11.3%). Penetrating keratoplasty (PKP) was the major technique used in repeat keratoplasty (447 cases, 84.2%). However, Descemet stripping endothelial keratoplasty was more frequently used than PKP (72.4% vs. 27.6%, P < 0.001) in the treatment of failed endothelial keratoplasty. Conclusion Infectious keratitis was still the leading cause of repeat keratoplasty in eastern China. Although PKP remains the major technique of repeat keratoplasty, the application of customized lamellar keratoplasty has greatly expanded in the last decade. Cautious selection of indications, surgical techniques, and timing for surgery is crucial for a good prognosis after repeat keratoplasty.
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Al-Sharif EM, Alkharashi M. Indications, surgical procedures and outcomes of keratoplasty at a Tertiary University-based hospital: a review of 10 years' experience. Int Ophthalmol 2021; 41:957-72. [PMID: 33625652 DOI: 10.1007/s10792-021-01731-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 10/29/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To investigate keratoplasty outcomes in a university-based hospital. METHODS Medical records of all patients undergoing keratoplasty at King Abdulaziz University Hospital, Riyadh, Saudi Arabia, between January 1, 2006, and December 31, 2015, with a minimum follow-up period of three months were reviewed retrospectively. Indications, surgical procedures, complications and outcomes of all surgeries were collected and analyzed. MAIN OUTCOME MEASURES Graft survival and visual acuity. RESULTS Data were available for 488 grafts in the study period, including 313 optical penetrating keratoplasty (PKP), 42 therapeutic/tectonic PKPs, 72 deep anterior lamellar keratoplasty, 58 Descemet's stripping automated endothelial keratoplasty and 3 Descemet's membrane endothelial keratoplasty. A total of 389 (79.7%) grafts survived, whereas 99 (20.3%) grafts failed. The projected 1-year, 3-year and 5-year cumulative survival rates for the entire study group were 85.8%, 74.9% and 71.1%, respectively. Corneal ectasia was the commonest surgical indication accounting for 48% of the cases. The best long-term survival rates were observed in the stromal dystrophy and corneal ectasia groups. The worst survival rates were noticed in the congenital corneal opacities group. Vision improved in in 57.5% of grafted eyes, remained the same in 39.8% and deteriorated in 2.7%. Postoperative complications occurred in 36% of the grafts with rejection being the most common, and its mere occurrence increased the risk of graft failure by 20-fold. CONCLUSION The outcome of grafting in a university-based hospital can be excellent in low-risk grafts and fair to low in high-risk grafts. Our results are relatively comparable to nationally and internationally reported outcomes.
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Pluzsik MT, Tóth G, Tóth J, Matolcsy A, Langenbucher A, Kerényi Á, Nagy ZZ, Szentmáry N. Changing trends in penetrating keratoplasty indications at a tertiary eye care center in Budapest, Hungary between 2006 and 2017. Int J Ophthalmol 2020; 13:1814-1819. [PMID: 33215015 DOI: 10.18240/ijo.2020.11.20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 10/23/2019] [Indexed: 11/23/2022] Open
Abstract
AIM To analyze the changing trends in penetrating keratoplasty (PKP) indications. METHODS This retrospective study included all patients with PKP between 2006 and 2017. Patients were classified using histological diagnoses. Our groups were as the following: pseudophakic or aphakic bullous keratopathy, regraft, acute necrotizing and ulcerative keratitis, keratoconus, Fuchs' dystrophy, corneal dystrophy other than Fuchs', corneal scar, other diagnoses and failed endothelial keratoplasty graft. Additionally, two different time-periods (2006-2012 and 2013-2017) were analysed. RESULTS Totally 1721 histological analyses of 1214 patients were available for review. The diagnoses were pseudophakic or aphakic bullous keratopathy in 487 (28.3%), regraft in 443 (25.7%), acute necrotizing and ulcerative keratitis in 313 (18.2%), corneal scar in 153 (8.9%), keratoconus in 140 (8.1%). Fuchs' dystrophy in 61 (3.5%), corneal dystrophy other than Fuchs' in 46 (2.7%), other diagnoses in 44 (2.6%) and failed endothelial keratoplasty graft in 34 (2.0%) cases. From the first to the second analysed time-period, incidence of acute necrotizing and ulcerative keratitis, corneal scar, Fuchs' dystrophy increased (P≤0.032 for all) and incidence of keratoconus significantly decreased (P=0.015). CONCLUSION Pseudophakic or aphakic bullous keratopathy is the leading indication for PKP, followed by regraft and acute necrotizing and ulcerative keratitis.
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Affiliation(s)
- Milán Tamás Pluzsik
- Department of Ophthalmology, Semmelweis University, Budapest 1085, Hungary.,Department of Ophthalmology, Bajcsy-Zsilinszky Hospital, Budapest 1106, Hungary
| | - Gábor Tóth
- Department of Ophthalmology, Semmelweis University, Budapest 1085, Hungary
| | - Jeannette Tóth
- 2nd Department of Pathology, Semmelweis University, Budapest 1091, Hungary
| | - András Matolcsy
- 1st Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest 1085, Hungary
| | - Achim Langenbucher
- Experimental Ophthalmology, Saarland University, Homburg/Saar 66421, Germany
| | - Ágnes Kerényi
- Department of Ophthalmology, Bajcsy-Zsilinszky Hospital, Budapest 1106, Hungary
| | - Zoltán Zsolt Nagy
- Department of Ophthalmology, Semmelweis University, Budapest 1085, Hungary
| | - Nóra Szentmáry
- Department of Ophthalmology, Semmelweis University, Budapest 1085, Hungary.,Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Congenital Aniridia Research, Saarland University Homburg/Saar 66424, Germany
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Gao H, Huang T, Pan Z, Wu J, Xu J, Hong J, Chen W, Wu H, Kang Q, Zhu L, Fu L, Wang L, Li G, Deng Z, Zhang H, Xu H, Zhao Q, Liu H, Wang L, Chen B, Jin X, Huang M, Yang J, Gao M, Zhou W, Xie H, Fu Y, Wen F, Fu C, Zhao S, Yang Y, Fu Y, Yao T, Wang C, Sun X, Gao X, Reziwan M, Deng Y, Li J, Liu L, Zeng B, Bao L, Wang H, Zhang L, Li Z, Yin Z, Wen Y, Zheng X, Du L, Huang Z, Sheng X, Zhang H, Chen L, Yan X, Liu X, Liu W, Liu Y, Liang L, Wu P, Qu L, Cheng J, Zhang H, Qi Q, Tseten Y, Ji J, Yuan J, Jie Y, Xiang J, Huang Y, Yang Y, Li Y, Hou Y, Liu T, Xie L, Shi W. Survey report on keratoplasty in China: A 5-year review from 2014 to 2018. PLoS One 2020; 15:e0239939. [PMID: 33057425 PMCID: PMC7561196 DOI: 10.1371/journal.pone.0239939] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 09/15/2020] [Indexed: 02/05/2023] Open
Abstract
To provide the general information on corneal transplantation (CT) in China, China Cornea Society designed a questionnaire on CT from 2014 to 2018 and entrusted it to 31 committee members for implementation of the survey nationwide. This article presents the results of the survey and compares the indicators used in the survey and those in the annual statistical report released by the Eye Bank Association of America (EBAA). The number of corneal transplantations completed by the 64 hospitals from 2014 to 2018 was respectively 5377, 6394, 7595, 8270 and 8980, totally 36,616 (22,959 male and 13,657 female). The five largest hospitals by the number of corneal transplantations completed 15,994 surgeries in total, accounting for 43.68% of all the surgeries performed in the 64 hospitals. The most common indication for corneal transplantations was corneal leukoma (7683, 20.98%), followed by bacterial keratitis (4209, 11.49%), corneal dystrophies (4189, 11.44%), keratoconus (3578, 9.77%) and corneal perforation (2839, 7.75%). The main surgical techniques were penetrating keratoplasty (PK) (19,896, 54.34%), anterior lamellar keratoplasty (ALK) (13,869, 37.88%). The proportion of PK decreased from 57.97% in 2014 to 52.88% in 2018 while the proportion of ALK increased from 36.04% in 2014 to 37.92% in 2018. The geographical distribution of keratoplasties performed in China is unbalanced. PK and ALK were the main techniques of CT and corneal leukoma, bacterial keratitis and corneal dystrophies were the main indications for CT in China.
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Affiliation(s)
- Hua Gao
- Department of Ophthalmology, Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
- Corneal Disease Group of Ophthalmological Society of Chinese Medical Association (China Cornea Society), Jinan, China
| | - Ting Huang
- Corneal Disease Group of Ophthalmological Society of Chinese Medical Association (China Cornea Society), Jinan, China
- Department of Ophthalmology, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou, China
| | - Zhiqiang Pan
- Corneal Disease Group of Ophthalmological Society of Chinese Medical Association (China Cornea Society), Jinan, China
- Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jie Wu
- Corneal Disease Group of Ophthalmological Society of Chinese Medical Association (China Cornea Society), Jinan, China
- Department of Ophthalmology, No.1 Hospital of Xi’an City, Xian, China
| | - Jianjiang Xu
- Corneal Disease Group of Ophthalmological Society of Chinese Medical Association (China Cornea Society), Jinan, China
- Department of Ophthalmology, Eye and Ear, Nose, Throat Hospital, Fudan University, Shanghai, China
| | - Jing Hong
- Corneal Disease Group of Ophthalmological Society of Chinese Medical Association (China Cornea Society), Jinan, China
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Wei Chen
- Corneal Disease Group of Ophthalmological Society of Chinese Medical Association (China Cornea Society), Jinan, China
- Department of Ophthalmology, Eye Hospital of Wenzhou Medical University, Wenzhou, China
| | - Huping Wu
- Department of Ophthalmology, Affiliated Xiamen Eye Center of Xiamen University, Xiamen, China
| | - Qian Kang
- Department of Ophthalmology, Chengdu AiDi Eye Hospital, Chengdu, China
| | - Lei Zhu
- Corneal Disease Group of Ophthalmological Society of Chinese Medical Association (China Cornea Society), Jinan, China
- Department of Ophthalmology, Henan Eye Institute, Henan Eye Hospital, Zhengzhou, China
| | - Lingling Fu
- Department of Ophthalmology, Hefei Puri Ophthalmological Hospital, Hefei, China
| | - Liqiang Wang
- Corneal Disease Group of Ophthalmological Society of Chinese Medical Association (China Cornea Society), Jinan, China
- Department of Ophthalmology, Chinese PLA General Hospital, Medical School of Chinese PLA, Beijing, China
| | - Guigang Li
- Corneal Disease Group of Ophthalmological Society of Chinese Medical Association (China Cornea Society), Jinan, China
- Department of Ophthalmology, TongJi Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhihong Deng
- Department of Ophthalmology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Hong Zhang
- Corneal Disease Group of Ophthalmological Society of Chinese Medical Association (China Cornea Society), Jinan, China
- Department of Ophthalmology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Hui Xu
- Department of Ophthalmology, The First Hospital of Jilin University, Changchun, China
| | - Qingliang Zhao
- Department of Ophthalmology, Suzhou Lixiang Eye Hospital, Suzhou, China
| | - Hongshan Liu
- Department of Ophthalmology, Hainan Eye Institute, Hainan Eye Hospital, Haikou, China
| | - Linnong Wang
- Corneal Disease Group of Ophthalmological Society of Chinese Medical Association (China Cornea Society), Jinan, China
- Department of Ophthalmology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Baihua Chen
- Corneal Disease Group of Ophthalmological Society of Chinese Medical Association (China Cornea Society), Jinan, China
- Department of Ophthalmology, Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiuming Jin
- Corneal Disease Group of Ophthalmological Society of Chinese Medical Association (China Cornea Society), Jinan, China
- Department of Ophthalmology, Affiliated Second Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Minghai Huang
- Department of Ophthalmology, Nanning Aier Eye Hospital, Nanning, China
| | - Jizhong Yang
- Department of Ophthalmology, Shanxi Eye Hospital, Taiyuan, China
| | - Minghong Gao
- Corneal Disease Group of Ophthalmological Society of Chinese Medical Association (China Cornea Society), Jinan, China
- Department of Ophthalmology, General Hospital of Northern Theater Command Hospital, Shenyang, China
| | - Wentian Zhou
- Department of Ophthalmology, Affiliated Eye Hospital of Nanchang University, Nanchang, China
| | - Hanping Xie
- Corneal Disease Group of Ophthalmological Society of Chinese Medical Association (China Cornea Society), Jinan, China
- Department of Ophthalmology, The First Hospital Affiliated to Army Medical University, Chongqing, China
| | - Yao Fu
- Corneal Disease Group of Ophthalmological Society of Chinese Medical Association (China Cornea Society), Jinan, China
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Feng Wen
- Department of Ophthalmology, Ningbo Eye Hospital, Ningbo, China
| | - Changbo Fu
- Department of Ophthalmology, Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University, Xuzhou, China
| | - Shaozhen Zhao
- Corneal Disease Group of Ophthalmological Society of Chinese Medical Association (China Cornea Society), Jinan, China
- Department of Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Yanning Yang
- Corneal Disease Group of Ophthalmological Society of Chinese Medical Association (China Cornea Society), Jinan, China
- Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yanjiang Fu
- Department of Ophthalmology, Daqing Ophthalmologic Hospital, Daqing, China
| | - Tao Yao
- Department of Ophthalmology, Shenyang He Eye Hospital, Shenyang, China
| | - Chaoqing Wang
- Department of Ophthalmology, Jinan Mingshui Eye Hospital, Jinan, China
| | - Xiaonan Sun
- Department of Ophthalmology, The 4th People's Hospital of Shenyang, Shenyang, China
| | - Xiaowei Gao
- Corneal Disease Group of Ophthalmological Society of Chinese Medical Association (China Cornea Society), Jinan, China
- Department of Ophthalmology, 474 Hospital of PLA, Urumchi, China
| | - Maimaitiming Reziwan
- Department of Ophthalmology, Urumqi City Ophthalmology and Otolaryngology Hospital, Urumchi, China
| | - Yingping Deng
- Corneal Disease Group of Ophthalmological Society of Chinese Medical Association (China Cornea Society), Jinan, China
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, China
| | - Jian Li
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Limei Liu
- Department of Ophthalmology, Weifang Eye Hospital, Weifang, China
| | - Bo Zeng
- Department of Ophthalmology, General Hospital of the Central Theater of the Chinese People’s Liberation Army, Wuhan, China
| | - Lianyun Bao
- Department of Ophthalmology, Nanjing Ningyi Eye Center, Nanjing, China
| | - Hua Wang
- Corneal Disease Group of Ophthalmological Society of Chinese Medical Association (China Cornea Society), Jinan, China
- Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha, China
| | - Lijun Zhang
- Corneal Disease Group of Ophthalmological Society of Chinese Medical Association (China Cornea Society), Jinan, China
- Department of Ophthalmology, The People’s Third Hospital of Dalian, Dalian Medical University, Dalian, China
| | - Zhiyuan Li
- Department of Ophthalmology, The People's No.1 Hospital of Chenzhou, Chenzhou, China
| | - Zhijian Yin
- Department of Ophthalmology, The First Affiliated Hospital of Dali University, Dali, China
| | - Yuechun Wen
- Department of Ophthalmology, The First Affiliated Hospital of University of Science and Technology of China, Anhui Provincial Hospital, Hefei, China
| | - Xiao Zheng
- Department of Ophthalmology, The Army Characteristic Medical Center, Chongqing, China
| | - Liqun Du
- Department of Ophthalmology, Qilu Hospital of Shandong University, Jinan, China
| | - Zhenping Huang
- Department of Ophthalmology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Xunlun Sheng
- Department of Ophthalmology, Ningxia Eye Hospital, The People’s Hospital of Ningxia Hui Autonomous Region, Yinchuan, China
| | - Hui Zhang
- Corneal Disease Group of Ophthalmological Society of Chinese Medical Association (China Cornea Society), Jinan, China
- Department of Ophthalmology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Lizhong Chen
- Department of Ophthalmology, Lunan Eye Hospital, Linyi, China
| | - Xiaoming Yan
- Corneal Disease Group of Ophthalmological Society of Chinese Medical Association (China Cornea Society), Jinan, China
- Department of Ophthalmology, Peking University First Hospital, Beijing, China
| | - Xiaowei Liu
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenhui Liu
- Department of Ophthalmology, Wuxi Second People's Hospital, Wuxi, China
| | - Yuan Liu
- Department of Ophthalmology, Guizhou Jinglang Eye Hospital, Guiyang, China
| | - Liang Liang
- Department of Ophthalmology, Yichang Central People's Hospital, Yichang, China
| | - Pengcheng Wu
- Department of Ophthalmology, Lanzhou University Second Hospital, Lanzhou, China
| | - Lijun Qu
- Department of Ophthalmology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jinkui Cheng
- Department of Ophthalmology, Jingzhou First People's Hospital, Jingzhou, China
| | - Hua Zhang
- Department of Ophthalmology, Shijiazhuang No.1 Hospital, Shijiazhuang, China
| | - Qige Qi
- Department of Ophthalmology, Hulunbuir People's Hospital, Hulunbuir, China
| | - Yangkyi Tseten
- Department of Ophthalmology, Tibetan Traditional Tibet Medical Hospital of Tibet Autonomous Region, Lhasa, China
| | - Jianping Ji
- Department of Ophthalmology, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou, China
| | - Jin Yuan
- Corneal Disease Group of Ophthalmological Society of Chinese Medical Association (China Cornea Society), Jinan, China
- Department of Ophthalmology, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou, China
| | - Ying Jie
- Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jun Xiang
- Department of Ophthalmology, Eye and Ear, Nose, Throat Hospital, Fudan University, Shanghai, China
| | - Yifei Huang
- Corneal Disease Group of Ophthalmological Society of Chinese Medical Association (China Cornea Society), Jinan, China
- Department of Ophthalmology, Chinese PLA General Hospital, Medical School of Chinese PLA, Beijing, China
| | - Yuli Yang
- Corneal Disease Group of Ophthalmological Society of Chinese Medical Association (China Cornea Society), Jinan, China
- Department of Ophthalmology, The First Hospital Affiliated to Army Medical University, Chongqing, China
| | - Ying Li
- Corneal Disease Group of Ophthalmological Society of Chinese Medical Association (China Cornea Society), Jinan, China
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yiyi Hou
- Department of Ophthalmology, Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Tong Liu
- Department of Ophthalmology, Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Lixin Xie
- Corneal Disease Group of Ophthalmological Society of Chinese Medical Association (China Cornea Society), Jinan, China
- Department of Ophthalmology, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
- * E-mail: , (WS); (LX)
| | - Weiyun Shi
- Department of Ophthalmology, Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
- Corneal Disease Group of Ophthalmological Society of Chinese Medical Association (China Cornea Society), Jinan, China
- * E-mail: , (WS); (LX)
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8
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Sharma VK, Kumar S, Patyal S, Trehan HS, Yadav AK, Raji K, Singh A. Endothelial corneal transplants: indications, clinical profile and surgical outcomes in a tertiary care hospital. Med J Armed Forces India 2020; 76:166-171. [PMID: 32476714 DOI: 10.1016/j.mjafi.2018.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 11/29/2018] [Indexed: 11/27/2022] Open
Abstract
Background Endothelial keratoplasties have become the surgical procedure of choice over full thickness penetrating keratoplasty for corneal decompensation because of endothelial dysfunction. Methods A retrospective data review was performed from February 2016 to April 2017 for all the patients who underwent endothelial keratoplasty in a tertiary care center for Indian Armed Forces. Results A total of 161 corneal transplants were performed; endothelial keratoplasties accounted for 34 (21.1%) transplants. Most common indication was pseudophakic/aphakic bullous keratopathy followed by Ahmed glaucoma valve-related corneal decompensation and Fuchs' corneal dystrophy, respectively. Mean preoperative corneal thickness was 845.96 ± 106.9 microns. Mean lenticule thickness was 131.55 ± 42.47 microns with microkeratome for descemet stripping automated endothelial keratoplasty (DSAEK) and 174 ± 70.4 microns manually for descemet stripping endothelial keratoplasty (DSEK). Mean preoperative best-corrected visual acuity (BCVA) was 1.65 LogMAR (Snellen equivalent in meters 2/60 approx) which significantly improved to 0.82 LogMAR (Snellen equivalent in meters 6/36 approx) after surgery. In the DSAEK group, BCVA improved from 1.61 to 0.7 LogMAR, whereas in the DSEK group, the visual acuity improved from 1.7 to 0.94 LogMAR at one-month postoperative period. Postoperatively, two patients had graft detachment and had to undergo repeat DSAEK. Conclusion Study results suggest the similar trends in our tertiary care hospital as in other most advanced ophthalmic centers around the world for adoption of newer techniques of lamellar corneal transplants and their outcomes.
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Affiliation(s)
- Vijay Kumar Sharma
- Classified Specialist (Ophthalmology) and Anterior Segment Surgeon, Army Hospital (R&R), New Delhi, India
| | - Santosh Kumar
- Consultant, Eye Care and Laser Center, New Delhi, India
| | | | - Hemant S Trehan
- Senior Adviser & Head (Ophthalmology) and Vitreoretinal Surgeon, Army Hospital (R&R), New Delhi, India
| | - Arun Kumar Yadav
- Assistant Professor, Department of Community Medicine, Armed Forces Medical College, Pune 411040, India
| | - K Raji
- Senior Advisor (Ophthalmology) and Vitreoretinal Surgeon, Army Hospital (R&R), New Delhi, India
| | - Anirudh Singh
- Senior Advisor (Ophthalmology), Command Hospital (Air Force), Bengaluru, India
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9
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Pluzsik MT, Seitz B, Flockerzi FA, Langenbucher A, Tóth G, Bohle RM, Szentmáry N. Changing Trends in Penetrating Keratoplasty Indications between 2011 and 2018 - Histopathology of 2123 Corneal Buttons in a Single Center in Germany. Curr Eye Res 2020; 45:1199-1204. [PMID: 32114836 DOI: 10.1080/02713683.2020.1737716] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: To analyse the changing trends in penetrating keratoplasty indications between January 2011 and December 2018, at the Department of Ophthalmology, Saarland University Medical Center, Homburg/Saar, Germany. Patients and Methods: This is a retrospective review of 2123 corneal buttons of 1776 patients (1993 eyes, 56.0% males, age at the time of surgery 57.6 ± 18.7 years), who underwent penetrating keratoplasty (PKP) between January 2011 and December 2018. The classification was performed based on histological analysis and using the priority scheme of Brady et al., supplemented by a group of "failed endothelial keratoplasty grafts". Our groups were the following: pseudophakic or aphakic bullous keratopathy, regraft, failed endothelial keratoplasty graft, acute necrotizing and ulcerative keratitis, keratoconus, Fuchs' dystrophy, corneal dystrophy other than Fuchs', corneal scars and other diagnoses. Results: Between 2011 and 2018, keratoconus was the leading indication for PKP in 455 (21.5%) cases, followed by acute necrotizing and ulcerative keratitis in 384 (18.1%), regraft in 367 (17.3%), corneal scars in 350 (16.5%), pseudophakic or aphakic bullous keratopathy in 225 (10.6%), Fuchs' dystrophy in 194 (9.1%), other diagnoses in 64 (3.0%), corneal dystrophy other than Fuchs' in 52 (2.4%), and failed endothelial keratoplasty graft in 32 (1.5%) cases. Conclusions: With the introduction of posterior lamellar keratoplasty, keratoconus remains the leading PKP indication in our center with excimer laser-trephination on a routine basis. A trend towards increasing numbers can be observed regarding acute necrotizing and ulcerative keratitis patients and regrafts. However, the incidence of Fuchs' dystrophy decreased dramatically within PKP patients, with the introduction of posterior lamellar keratoplasty.
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Affiliation(s)
- Milán Tamás Pluzsik
- Department of Ophthalmology, Saarland University Medical Center, UKS , Homburg, Germany.,Department of Ophthalmology, Bajcsy-Zsilinszky Hospital , Budapest, Hungary
| | - Berthold Seitz
- Department of Ophthalmology, Saarland University Medical Center, UKS , Homburg, Germany
| | - Fidelis A Flockerzi
- Department of Pathology, Saarland University Medical Center, UKS , Homburg, Germany
| | | | - Gábor Tóth
- Department of Ophthalmology, Saarland University Medical Center, UKS , Homburg, Germany.,Department of Ophthalmology, Semmelweis University , Budapest, Hungary
| | - Rainer M Bohle
- Department of Pathology, Saarland University Medical Center, UKS , Homburg, Germany
| | - Nóra Szentmáry
- Department of Ophthalmology, Saarland University Medical Center, UKS , Homburg, Germany.,Department of Ophthalmology, Semmelweis University , Budapest, Hungary
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10
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Sun XT, Zhai HL, Cheng J, Kong QQ, Cong L, Li L, Hao WP. Indications for penetrating keratoplasty and anterior lamellar keratoplasty during 2010-2017. Int J Ophthalmol 2019; 12:1878-1884. [PMID: 31850172 DOI: 10.18240/ijo.2019.12.10] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 09/12/2019] [Indexed: 11/23/2022] Open
Abstract
AIM To review the indications of penetrating keratoplasty (PK) and anterior lamellar keratoplasty (ALK) at Qingdao Eye Hospital, Shandong Eye Institute, Qingdao, China, from 2010 to 2017. METHODS The data of all patients undergoing PK or ALK from January 2010 to December 2017 was retrospectively reviewed, with the indications during 2010-2013 and 2014-2017 compared. RESULTS A total of 1869 eyes were included, among which 1405 eyes (75.2%) had PK and 464 eyes (24.8%) had ALK. The leading indications were suppurative keratitis (36.8%), keratoconus (15.5%), herpes keratitis (13.1%), and regraft (10.5%). In eyes undergoing PK, the top four indications were suppurative keratitis (38.7%), herpes keratitis (15.3%), keratoconus (12.6%), and regraft (12.5%) during 2014-2017, with the proportion of suppurative keratitis and herpes keratitis decreased while regraft and keratoconus increased compared with 2010-2013. In eyes with ALK, suppurative keratitis (30.8%), keratoconus (24.1%), corneal dystrophies and degenerations (10.6%), and corneal dermoid tumor (9.7%) were the top four indications, and there was no significant difference for the proportion of each indication between 2010-2013 and 2014-2017. CONCLUSION Suppurative keratitis is the most common indication for PK and ALK at Qingdao Eye Hospital during 2010-2017, followed by keratoconus, herpes keratitis, and regraft. In eyes treated with PK, the proportion of suppurative keratitis and herpes keratitis decrease while regraft and keratoconus increase during 2014-2017 compared with 2010-2013.
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Affiliation(s)
- Xiao-Tong Sun
- Qingdao Eye Hospital of Shandong First Medical University, Shandong Eye Institute, Shandong Provincial Key Laboratory of Ophthalmology-State Key Laboratory Cultivation Base, Qingdao 266071, Shandong Province, China
| | - Hua-Lei Zhai
- Qingdao Eye Hospital of Shandong First Medical University, Shandong Eye Institute, Shandong Provincial Key Laboratory of Ophthalmology-State Key Laboratory Cultivation Base, Qingdao 266071, Shandong Province, China
| | - Jun Cheng
- Qingdao Eye Hospital of Shandong First Medical University, Shandong Eye Institute, Shandong Provincial Key Laboratory of Ophthalmology-State Key Laboratory Cultivation Base, Qingdao 266071, Shandong Province, China
| | - Qian-Qian Kong
- Qingdao Eye Hospital of Shandong First Medical University, Shandong Eye Institute, Shandong Provincial Key Laboratory of Ophthalmology-State Key Laboratory Cultivation Base, Qingdao 266071, Shandong Province, China
| | - Lin Cong
- Qingdao Eye Hospital of Shandong First Medical University, Shandong Eye Institute, Shandong Provincial Key Laboratory of Ophthalmology-State Key Laboratory Cultivation Base, Qingdao 266071, Shandong Province, China
| | - Lin Li
- Qingdao Eye Hospital of Shandong First Medical University, Shandong Eye Institute, Shandong Provincial Key Laboratory of Ophthalmology-State Key Laboratory Cultivation Base, Qingdao 266071, Shandong Province, China
| | - Wen-Pei Hao
- Qingdao Eye Hospital of Shandong First Medical University, Shandong Eye Institute, Shandong Provincial Key Laboratory of Ophthalmology-State Key Laboratory Cultivation Base, Qingdao 266071, Shandong Province, China
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Khor WB, Prajna VN, Garg P, Mehta JS, Xie L, Liu Z, Padilla MDB, Joo CK, Inoue Y, Goseyarakwong P, Hu FR, Nishida K, Kinoshita S, Puangsricharern V, Tan AL, Beuerman R, Young A, Sharma N, Haaland B, Mah FS, Tu EY, Stapleton FJ, Abbott RL, Tan DTH. The Asia Cornea Society Infectious Keratitis Study: A Prospective Multicenter Study of Infectious Keratitis in Asia. Am J Ophthalmol 2018; 195:161-170. [PMID: 30098351 DOI: 10.1016/j.ajo.2018.07.040] [Citation(s) in RCA: 126] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 07/26/2018] [Accepted: 07/28/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE To survey the demographics, risk factors, microbiology, and outcomes for infectious keratitis in Asia. DESIGN Prospective, nonrandomized clinical study. METHODS Thirteen study centers and 30 sub-centers recruited consecutive subjects over 12-18 months, and performed standardized data collection. A microbiological protocol standardized the processing and reporting of all isolates. Treatment of the infectious keratitis was decided by the managing ophthalmologist. Subjects were observed for up to 6 months. Main outcome measures were final visual acuity and the need for surgery during infection. RESULTS A total of 6626 eyes of 6563 subjects were studied. The majority of subjects were male (n = 3992). Trauma (n = 2279, 34.7%) and contact lens wear (n = 704, 10.7%) were the commonest risk factors. Overall, bacterial keratitis was diagnosed in 2521 eyes (38.0%) and fungal keratitis in 2166 eyes (32.7%). Of the 2831 microorganisms isolated, the most common were Fusarium species (n = 518, 18.3%), Pseudomonas aeruginosa (n = 302, 10.7%), and Aspergillus flavus (n = 236, 8.3%). Cornea transplantation was performed in 628 eyes to manage ongoing infection, but 289 grafts (46%) had failed by the end of the study. Moderate visual impairment (Snellen vision less than 20/60) was documented in 3478 eyes (53.6%). CONCLUSION Demographic and risk factors for infection vary by country, but infections occur predominantly in male subjects and are frequently related to trauma. Overall, a similar percentage of bacterial and fungal infections were diagnosed in this study. Visual recovery after infectious keratitis is guarded, and corneal transplantation for active infection is associated with a high failure rate.
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12
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Bigan G, Puyraveau M, Saleh M, Gain P, Martinache I, Delbosc B, Gauthier AS. Corneal transplantation trends in France from 2004 to 2015: A 12-year review. Eur J Ophthalmol 2018; 28:535-540. [DOI: 10.1177/1120672118762224] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose: 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.
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Affiliation(s)
- Guillaume Bigan
- Department of Ophthalmology, University Hospital of Besançon, Besançon, France
| | - Marc Puyraveau
- Clinical Trials Statistical, Faculty of Medicine, University of Franche-Comté, Besançon, France
| | - Maher Saleh
- Department of Ophthalmology, University Hospital of Besançon, Besançon, France
| | - Philippe Gain
- Department of Ophthalmology, Saint-Etienne University Hospital, France
| | | | - Bernard Delbosc
- Department of Ophthalmology, University Hospital of Besançon, Besançon, France
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13
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Bozkurt TK, Acar B, Kilavuzoglu AE, Akdemir MO, Hamilton DR, Cosar Yurteri CB, Acar S. An 11-Year Review of Keratoplasty in a Tertiary Referral Center in Turkey: Changing Surgical Techniques for Similar Indications. Eye Contact Lens 2017; 43:364-70. [PMID: 27203794 DOI: 10.1097/ICL.0000000000000274] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Study aims to evaluate the indications and surgical techniques for corneal transplantation and to report changes in trends for preferred keratoplasty surgical techniques. METHODS Clinical records of 815 consecutive corneal transplantations between January 1, 2004 and December 31, 2014 in Haydarpasa Numune Training and Research Hospital Eye Clinic were analyzed and classified into seven broad groups according to indications. Main outcome measures were change of leading indications and trends for surgical techniques. RESULTS Leading indications for keratoplasty were keratoconus (KCN) (27.7%), bullous keratopathy (BK) (23%), postinfectious corneal scars (13.5%), regrafts (13.1%), corneal dystrophies (12.1%), and noninfectious corneal scars (5.4%). Regrafts were the only indication with a significantly increasing trend (P<0.01). Since the introduction of lamellar keratoplasty (LK) techniques including deep anterior lamellar keratoplasty (DALK) and Descemet stripping automated endothelial keratoplasty (DSAEK), there was a significant increasing trend in number and percentage of both LK techniques (DALK; P=0.001 and P=0.007, and DSAEK; P<0.001 and P<0.001, respectively) and a significant corresponding decline in the percentage of penetrating keratoplasty (PK) (P<0.01). Similarly, DALK and DSAEK replaced PK as the preferred surgical technique for KCN and BK indications, (P=0.007 and P=0.01, respectively). Although PK was the most common surgical technique over the 11-year period (54.7%), both anterior and posterior LK techniques showed an emerging trend as the procedures of choice when indicated. CONCLUSIONS No major shift was observed in the clinical indications for corneal transplantation over the previous 11 years, except for regrafts. Lamellar keratoplasty techniques largely overtook the PK technique, but PK was still the overall preferred technique in the era when both LK techniques were used.
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14
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Hao XD, Chen P, Zhang YY, Li SX, Shi WY, Gao H. De novo mutations of TUBA3D are associated with keratoconus. Sci Rep 2017; 7:13570. [PMID: 29051577 DOI: 10.1038/s41598-017-13162-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 09/19/2017] [Indexed: 11/08/2022] Open
Abstract
Keratoconus (KC) is a common degenerative corneal disease, and heredity plays a key role in its development. Although few genes are known to cause KC, a large proportion of disease-causing genes remain to be revealed. Here, we report the identification of TUBA3D as a novel gene linked to KC. Using whole-exome sequencing of a twins pedigree, a novel de novo mutation (c.31 C > T, p.Gln11stop) in TUBA3D gene was identified. A screening performed in 200 additional unrelated patients with KC revealed another two mutations (c.201insTT, p.Val68Leufs*2; c.*2 G > A) in two patients. TUBA3D was expressed highly in the cornea, and the twins had lower TUBA3D expression and higher UPA and MMP1 expressions than the normal parents. Through function prediction and in vitro cell experiment, we further demonstrated that the mutant proteins of TUBA3D were unstable and could lead to human corneal fibroblast cells performing higher MMPs expression and oxidative stress. These changes thus reduce the amount of extracellular matrices within corneas and undoubtedly play a major role in stromal thinning, which is characteristic of KC corneas. Our study showed that TUBA3D is a new gene that causes KC, thus supporting the evidence that this protein has an additional function into the human cornea.
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15
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Matthaei M, Sandhaeger H, Hermel M, Adler W, Jun AS, Cursiefen C, Heindl LM. Changing Indications in Penetrating Keratoplasty: A Systematic Review of 34 Years of Global Reporting. Transplantation 2017; 101:1387-99. [PMID: 27336399 DOI: 10.1097/TP.0000000000001281] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Penetrating keratoplasty (PK) ranks among the oldest and most common kinds of human tissue transplantation. Based on the hypothesis that reported indications for PK significantly vary between global regions and over time, the present systematic review aimed to provide a thorough overview of global PK indications as reported in peer-reviewed manuscripts. METHODS A literature search of PubMed and MEDLINE was conducted to retrieve articles published from January 1980 to May 2014. Indications for PK within 7 global regions were compared using a modified classification system for PK indications and analyzed via multivariate regression. RESULTS A total of 141 publications from 37 countries were included, recording 180 865 PK cases. Postcataract surgery edema was the predominant indication in North America (28.0%) and ranked second in Europe (20.6%), Australia (21.1%), the Middle East (13.6%), Asia (15.5%), and South America (18.6%). Keratoconus was the leading indication in Europe (24.2%), Australia (33.2%), the Middle East (32.8%), Africa (32.4%), and South America (22.8%). It ranked third in North America (14.2%). Keratitis was the primary indication in Asia (32.3%). Fuchs endothelial corneal dystrophy was the fourth most common indication in North America (12.9%) and Europe (10.2%) and fifth in South America (3.8%). Multivariate analysis supported these results and revealed individual regional changes over time. CONCLUSIONS Systematic analysis reveals characteristic chronological and regional differences in reported global PK indications. Leading reported indications for PK between 1980 and 2014 were keratoconus (Europe, Australia, the Middle East, Africa, and South America), pseudophakic bullous keratopathy/aphakic bullous keratopathy (North America), and keratitis (Asia).
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16
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Chen Y, Gao M, Duncan JK, Ran D, Roe DJ, Belin MW, Wang M. Excisional keratectomy combined with focal cryotherapy and amniotic membrane inlay for recalcitrant filamentary fungal keratitis: A retrospective comparative clinical data analysis. Exp Ther Med 2016; 12:3014-3020. [PMID: 27882109 DOI: 10.3892/etm.2016.3699] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 07/21/2016] [Indexed: 12/23/2022] Open
Abstract
The aim of the present study was to investigate the efficacy of a novel surgical intervention, excisional keratectomy combined with focal cryotherapy and amniotic membrane inlay (EKCAI), for the treatment of recalcitrant filamentary fungal keratitis. A retrospective analysis was performed of patients who underwent excisional keratectomy combined with conjunctival flap inlay (EKCFI), EKCAI or therapeutic penetrating keratoplasty (TPK) from January 2006 to January 2011. Recalcitrance was determined as being unresponsive to standard medical antifungal therapy for at ≥1 week. Outcome measures among the three intervention modalities were compared. A total of 128 patients had a follow-up of ≥1 year after the primary intervention. The success rates of interventions at 1-year follow-up were 58.33% in the EKCFI group, 88.37% in the EKCAI group and 93.44% in the TPK group (P<0.0002). The preoperative visual acuity of the three groups were similar (P=0.6458), while the postoperative best-corrected visual acuity (BCVA) of patients without recurrence was significantly different among the three groups 3 months after surgery. The best postoperative BCVA was found in the TPK group, while the worst was in the EKCFI group. In conclusion, EKCAI does not require donor cornea, is straightforward surgically, and has a favorable success rate compared with EKCFI.
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Affiliation(s)
- Yingxin Chen
- Department of Ophthalmology, The General Hospital of Shenyang Military Command, Shenyang, Liaoning 110016, P.R. China
| | - Minghong Gao
- Department of Ophthalmology, The General Hospital of Shenyang Military Command, Shenyang, Liaoning 110016, P.R. China
| | - Joshua K Duncan
- Department of Ophthalmology and Visual Science, College of Medicine, The University of Arizona, Tucson, AZ 85711, USA
| | - Di Ran
- Epidemiology and Biostatistics Division, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ 85724, USA
| | - Denise J Roe
- Epidemiology and Biostatistics Division, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ 85724, USA
| | - Michael W Belin
- Department of Ophthalmology and Visual Science, College of Medicine, The University of Arizona, Tucson, AZ 85711, USA
| | - Mingwu Wang
- Department of Ophthalmology and Visual Science, College of Medicine, The University of Arizona, Tucson, AZ 85711, USA
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Le R, Yucel N, Khattak S, Yucel YH, Prud'homme GJ, Gupta N. Current indications and surgical approaches to corneal transplants at the University of Toronto: A clinical-pathological study. Can J Ophthalmol 2016; 52:74-79. [PMID: 28237153 DOI: 10.1016/j.jcjo.2016.07.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 06/07/2016] [Accepted: 07/06/2016] [Indexed: 11/27/2022]
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.
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Affiliation(s)
- Ryan Le
- Keenan Research Centre for Biomedical Science at the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ont
| | - Narain Yucel
- 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
| | - Shireen Khattak
- 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
| | - Yeni H Yucel
- 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
| | - Gerald J Prud'homme
- 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
| | - Neeru Gupta
- 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.
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Wisse RPL, van den Hoven CML, Van der Lelij A. Does lamellar surgery for keratoconus experience the popularity it deserves? Acta Ophthalmol 2014; 92:473-7. [PMID: 24131774 DOI: 10.1111/aos.12281] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Accepted: 08/25/2013] [Indexed: 11/30/2022]
Abstract
PURPOSE To analyse developments in surgical treatment for keratoconus (KC) by assessing rates and types of corneal surgery from 2005 to 2010. METHODS The Dutch Transplantation Foundation supplied data on all keratoplasty procedures for KC performed from 2005 to 2010 in the Netherlands. Registration was carried out by the eyebank at allocation and by the surgeon at the time of surgery. The type of surgery was categorized as either a penetrating or a lamellar procedure. RESULTS Five hundred and seventy-five anonymized records were received, with excellent data completion (99%). Patients undergoing penetrating surgery had on average a lower visual acuity, higher k-readings and were slightly older compared with the lamellar group. A previous corneal hydrops was recorded for 19.1% of patients. Regular penetrating keratoplasty decreased in popularity from 79.7% in 2005 to 43.7% in 2010, due to the increased rate of lamellar surgery (42.5% in 2010) and 'mushroom' penetrating keratoplasty (13.8% in 2010). When hydrops cases were excluded, popularity became equal (47.6% penetrating versus 52.4% lamellar surgery, in 2010). CONCLUSION Lamellar surgery is gaining in popularity, although regular penetrating keratoplasty is still the more commonly performed procedure. Only when hydrops cases are excluded do transplant rates become comparable.
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Affiliation(s)
- Robert P. L. Wisse
- Department of Ophthalmology; University Medical Center Utrecht; Utrecht Netherlands
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Tan JCH, Holland SP, Dubord PJ, Moloney G, Mccarthy M, Yeung SN. Evolving Indications for and Trends in Keratoplasty in British Columbia, Canada, From 2002 to 2011: A 10-Year Review. Cornea 2014; 33:252-6. [DOI: 10.1097/ico.0000000000000066] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Galvis V, Tello A, Gomez AJ, Rangel CM, Prada4 AM, Camacho PA. Corneal transplantation at an ophthalmological referral center in Colombia: indications and techniques (2004-2011). Open Ophthalmol J 2013; 7:30-3. [PMID: 23898357 PMCID: PMC3722533 DOI: 10.2174/1874364101307010030] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 06/19/2013] [Accepted: 06/20/2013] [Indexed: 11/27/2022] Open
Abstract
Purpose: To analize changing trends in indications and surgical techniques of corneal transplantation at an ophthalmological tertiary referral center in Colombia over a 7 year period. Methods: A retrospective analysis was performed of medical records from patients who underwent corneal transplantation surgeries at Fundación Oftalmológica de Santander (FOSCAL) in Bucaramanga, Colombia, between August 2004 and August 2011. Results: During this period from a total of 450 corneal transplants performed, we had access to 402 medical records (89.4%). The patients’ mean age was 55. Leading indications were: pseudophakic/aphakic bullous kerathopathy (PBK/ABK) (34.6%), corneal scar (15.7%), active infectious keratitis (14.4%) and keratoconus (12.7%). During the first period (2004-2007) PBK/ABK was the leading indication, followed by stromal opacities and keratoconus. During the second period (2008-2011) PBK/ABK remained the leading indication. Infectious keratitis, however, became the second most common indication. Stromal opacities and keratoconus, moved to third and fourth, respectively. All transplants performed in the first period (2004-2007) were penetrating keratoplasties. In the second period (2008-2011) 18.7% of the procedures were performed using the Descemet’s stripping automated endothelial keratoplasty technique (DSAEK). Conclusions: Similar to other international results, PBK/ABK was the leading indication for corneal transplantation at our institution. Keratoconus is becoming a less common indication for keratoplasty in our institution. Infectious keratitis remains a frequent indication for corneal transplantation in this geographical area. In our institution we started performing DSAEK in 2009, and it is emerging as the procedure of choice in corneal diseases that involve only the endothelial layers.
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Affiliation(s)
- Virgilio Galvis
- Centro Oftalmológico Virgilio Galvis, Floridablanca, Colombia ; Fundación Oftalmológica de Santander-Clínica Carlos Ardila Lulle (FOSCAL), Floridablanca, Colombia ; Health Faculty, Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia
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Cunningham WJ, Brookes NH, Twohill HC, Moffatt SL, Pendergrast DGC, Stewart JM, McGhee CNJ. Trends in the distribution of donor corneal tissue and indications for corneal transplantation: the New Zealand National Eye Bank Study 2000-2009. Clin Exp Ophthalmol 2011; 40:141-7. [DOI: 10.1111/j.1442-9071.2011.02681.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Wang JY, Xie LX, Song XS, Zhao J. Trends in the indications for penetrating keratoplasty in Shandong, 2005-2010. Int J Ophthalmol 2011; 4:492-7. [PMID: 22553709 DOI: 10.3980/j.issn.2222-3959.2011.05.07] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2011] [Accepted: 10/08/2011] [Indexed: 11/02/2022] Open
Abstract
AIM To identify the current indications and the trend shifts for penetrating keratoplasty (PKP) in Shandong. METHODS The medical charts of all patients who underwent PKP at Shandong Eye Institute from June 1, 2005 to May 31, 2010 were analysed retrospectively. RESULTS A total of 875 patients (875 eyes) received PKP in this 5-year period, accounting for 61.6% of all corneal transplantation surgeries. The leading indications for PKP were infectious keratitis (37.1%), HSK (19.1%), keratoconus (11.2%), bullous keratopathy (8.5%), regrafting (6.7%) and corneal scarring (4.8%). The percentage of PKP for keratoconus declined year by year, whereas the percentage of bullous keratopathy had a mild annual increase. Fungal infections accounted for 65.2% of the infectious keratitis cases, remaining the leading cause of corneal infection. In addition, 54.1% of bullous keratopathy cases were associated with cataract surgery. The leading initial diagnoses associated with regrafting were infectious keratitis (38.9%), HSK (18.6%) and corneal burn (16.9%). The major causes of regrafting included graft endothelial dysfunction (39.0%), graft ulcer (28.8%) and primary disease recurrence (15.3%). CONCLUSION Infectious keratitis remained the leading indication for PKP in Shandong, and fungal infections were still the major cause of corneal infections. There was an increasing trend in the percentage of PKP cases indicated for bullous keratopathy but a decline in the same for keratoconus. Even with a decline in the overall proportion among all corneal transplantation surgeries, PKP is still the major corneal transplant choice in Shandong.
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Affiliation(s)
- Jun-Yi Wang
- Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China
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