scholarly journals Trends in Corneal Transplantation and Characteristics of Donors in the Chongqing Eye Bank, China: A Retrospective Study, 1999–2018

2021 ◽  
Vol 8 ◽  
Author(s):  
Handan Tan ◽  
Meng Lin ◽  
Qingqing Gou ◽  
Aijia Li ◽  
Fengjuan Gu ◽  
...  
Keyword(s):  
Penetrating Keratoplasty ◽  
Corneal Transplantation ◽  
Education Level ◽  
Lamellar Keratoplasty ◽  
Infectious Keratitis ◽  
Eye Bank ◽  
Female Ratio ◽  
Anterior Lamellar Keratoplasty ◽  
Department Of Ophthalmology ◽  
Per Capita

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.

scholarly journals Infectious keratitis in Vietnam: etiology, organisms, and management at Vietnam National Eye Hospital

2022 ◽  
Vol 15 (1) ◽  
pp. 128-134
Author(s):  
Pham Ngoc Dong ◽  
◽  
Nguyen Thi Nga Duong ◽  
Mai Thi Lien ◽  
Angela C. Chen ◽  
...  
Keyword(s):  
Risk Factor ◽  
Ocular Trauma ◽  
Corneal Transplantation ◽  
Treatment Programs ◽  
Lamellar Keratoplasty ◽  
Infectious Keratitis ◽  
Streptococcus Pneumonia ◽  
Anterior Lamellar Keratoplasty ◽  
Medical Histories ◽  
Bacteria And Fungi

AIM: To report the etiologies, risk factors, treatments, and outcomes of infectious keratitis (IK) at a major Vietnamese eye hospital. METHODS: This is a retrospective review of all cases of IK at Vietnam National Eye Hospital (VNEH) in Hanoi, Vietnam. Medical histories, demographics, clinical features, microbiological results, and treatment outcomes were reviewed. RESULTS: IK was diagnosed in 1974 eyes of 1952 patients, with ocular trauma being the greatest risk factor for IK (34.2%), frequently resulting from an agriculture-related injury (53.3%). The mean duration between symptom onset and presentation to VNEH was 19.3±14.4d, and 98.7% of patients had been treated with topical antibiotic and/or antifungal agents prior to evaluation at VNEH. Based on smear results of 1706 samples, the most common organisms identified were bacteria (n=1107, 64.9%) and fungi (n=1092, 64.0%), with identification of both bacteria and fungi in 614 (36.0%) eyes. Fifty-five of 374 bacterial cultures (14.7%) and 426 of 838 fungal cultures (50.8%) were positive, with the most commonly cultured pathogens being Pseudomonas aeruginosa, Streptococcus pneumonia, Fusarium spp., and Aspergillus spp. Corneal perforation and descemetocele developed in 391 (19.8%) and 93 (4.7%) eyes, respectively. Medical treatment was successful in resolving IK in 50.4% eyes, while 337 (17.1%) eyes underwent penetrating or anterior lamellar keratoplasty. Evisceration was performed in 7.1% of eyes, most commonly in the setting of fungal keratitis. CONCLUSION: Ocular trauma is a major risk factor for IK in Vietnam, which is diagnosed in almost 400 patients each year at VNEH. Given this, and as approximately one quarter of the eyes that develop IK require corneal transplantation or evisceration, greater emphasis should be placed on the development of prevention and treatment programs for IK in Vietnam.

scholarly journals Recurrent Keratoconus

2013 ◽  
Vol 2 (2) ◽  
pp. 65-68
Keyword(s):  
Penetrating Keratoplasty ◽  
Treatment Options ◽  
Corneal Transplantation ◽  
Wound Dehiscence ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Time To Recurrence ◽  
Anterior Lamellar Keratoplasty ◽  
Corneal Thinning ◽  
Corneal Disorder

Abstract Keratoconus is an ectatic corneal disorder characterized by progressive corneal thinning and protrusion. Keratoconus recurrence after corneal transplantation although rare is present and has been confirmed histologically. Host, donor, genetic, mechanical and environmental factors have been proposed as predisposing factors to initiate keratoconus recurrence. The time-to-recurrence post-deep anterior lamellar keratoplasty seems to occur earlier than after penetrating keratoplasty. Wound dehiscence and high astigmatism post-transplant are plausible differential diagnosis for this entity. The treatment options are similar to primary keratoconus. Since, the era of collagen corneal cross-linking, early diagnosis is desirable as it could halt the progression of recurrent keratoconus. How to cite this article Barbara R, Barbara A. Recurrent Keratoconus. Int J Kerat Ect Cor Dis 2013;2(2):65-68.

scholarly journals Malapposition of Graft-host Interface after Penetrating Keratoplasty (PK) and Deep Anterior lamellar Keratoplasty (DALK): an optical coherence tomography study

2019 ◽  
Author(s):  
Yujin Zhao ◽  
Hong Zhuang ◽  
Jiaxu Hong ◽  
Lijia Tian ◽  
Jianjiang Xu
Keyword(s):  
Optical Coherence Tomography ◽  
Penetrating Keratoplasty ◽  
Corneal Transplantation ◽  
Anterior Segment ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Optical Coherence ◽  
Visual Outcomes ◽  
Total Prevalence ◽  
Anterior Lamellar Keratoplasty

Abstract Backgroud: Previous studies of internal graft-host malappositions have not dealt with the precise ways in which each malapposition affected post-penetrating keratoplasty (post-PK) visual outcomes. In this study, we reviewed our post-PK and post-deep anterior lamellar keratoplasty (post-DALK) keratoconic patients and used anterior segment optical coherence tomography (AS-OCT) to evaluate the correlations between graft-host interface (GHI) characteristics and visual outcomes. Methods: Novel GHI metrics included: mean graft-host touch (GHT), total prevalence of malapposition proportion (Pm), frequency of apposition (F), size of malapposition (Sm), junctional graft thickness (Tg), and the absolute value of difference between Tg and Th (|Tg-Th|). We connected the external and internal junction points of GHI (GHT) and drew a straight line through the central point, perpendicular to both sides of the cornea. Tg and Th were the thicknesses at cross-points 1 mm away from the meeting point on the external side of the graft and host, respectively. Correlations between GHI metrics and postsurgical visual outcomes [ logarithm of minimum angle of resolution best-corrected visual acuity (logMAR BCVA), spherical equivalent diopter (SE), diopter of spherical power (DS), diopter of cylindrical power (DC) and keratometric astigmatism (Astig value)] were evaluated for 45 patients (one eye each). Results: 22 post-PK and 23 post-DALK keratoconic patients were enrolled. Compared with the regular-apposition results, GHT was decreased in step and gape patterns, and increased in hill and tag patterns. SE increased by 6.851, 5.428 and 5.164 times for every 1% increase in: F (step) [b=6.851; 95% Confidence interval (CI)=2.975-10.727; P=0.001]; F (graft step) [b=5.428; 95% CI=1.685-9.171; P=0.005]; and Pm [b=5.164; 95%CI=0.913-9.146; P=0.018], respectively. SE increased by 0.031 times for every 1-μm increment of |Tg-Th| [b=0.031; 95% CI=0.009-0.054; P=0.007]. LogMAR BCVA increased by 0.001 times for every 1-μm increment of both GHT [b=0.001; 95% CI=0-0.002; P=0.030]. and Tg [b=0.001; 95% CI=0.001-0.002; P=0.001]. Astig value increased by 0.017 times for 1-μm increment of Sm [b=0.017; 95% CI=0-0.033; P=0.047]. Conclusion: This investigation of GHI characteristics suggests explanations for varied ametropia in keratoconic eyes and has potential significance as a reference for promoting pre-surgical planning and technology for corneal transplantation.

scholarly journals Malapposition of Graft-host Interface after Penetrating Keratoplasty (PK) and Deep Anterior lamellar Keratoplasty (DALK): an optical coherence tomography study

2020 ◽  
Author(s):  
Yujin Zhao ◽  
Hong Zhuang ◽  
Jiaxu Hong ◽  
Lijia Tian ◽  
Jianjiang Xu
Keyword(s):  
Optical Coherence Tomography ◽  
Penetrating Keratoplasty ◽  
Linear Regression Analysis ◽  
Corneal Transplantation ◽  
Anterior Segment ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Optical Coherence ◽  
Visual Outcomes ◽  
Anterior Lamellar Keratoplasty

Abstract Backgroud: Previous studies of internal graft-host malappositions have not dealt with the precise ways in which each malapposition affected post-penetrating keratoplasty (post-PK) visual outcomes. In this study, we reviewed our post-PK and post-deep anterior lamellar keratoplasty (post-DALK) keratoconic patients and used anterior segment optical coherence tomography (AS-OCT) to evaluate the associations between graft-host interface (GHI) characteristics and visual outcomes. Methods: Novel GHI metrics included: mean graft-host touch (GHT), total prevalence of malapposition proportion (Pm), frequency of apposition (F), size of malapposition (Sm), junctional graft thickness (Tg), junctional host thickness (Th) and the absolute value of difference between Tg and Th (|Tg-Th|). We connected the external and internal junction points of GHI (GHT) and drew a straight line through the central point, perpendicular to both sides of the cornea. Tg and Th were the thicknesses at cross-points 1 mm away from the meeting point on the external side of the graft and host, respectively. Linear regression analysis was used to describe associations between GHI metrics and postsurgical visual outcomes [ logarithm of minimum angle of resolution best-corrected visual acuity (logMAR BCVA), spherical equivalent diopter (SE), diopter of spherical power (DS), diopter of cylindrical power (DC) and keratometric astigmatism (Astig value)]. Results: We enrolled 22 post-PK and 23 post-DALK keratoconic patients. Compared with the regular-apposition results, GHT was decreased in step and gape patterns, and increased in hill and tag patterns. SE increased averagely by 6.851, 5.428 and 5.164 diopter per 1% increase in: F (step) [β=6.851; 95% Confidence interval (CI)=2.975-10.727; P=0.001]; F (graft step) [β=5.428; 95% CI=1.685-9.171; P=0.005]; and Pm [β=5.164; 95%CI=0.913-9.146; P=0.018], respectively. SE increased averagely by 0.31 diopter per 10-μm increment in |Tg-Th| [β=0.031; 95% CI=0.009-0.054; P=0.007]. LogMAR BCVA increased (on average) by 0.01 per 10-μm increment in both GHT [β=0.001; 95% CI=0-0.002; P=0.030]. and Tg [β=0.001; 95% CI=0.001-0.002; P=0.001]. Astig value increased on average by 0.17 diopter per 10-μm increment in Sm [β=0.017; 95% CI=0-0.033; P=0.047]. Conclusion: This investigation of GHI characteristics suggests explanations for varied ametropia in keratoconic eyes and has potential significance as a reference for promoting pre-surgical planning and technology for corneal transplantation.

Corneal transplantation trends in France from 2004 to 2015: A 12-year review

2018 ◽  
Vol 28 (5) ◽  
pp. 535-540 ◽  
Author(s):  
Guillaume Bigan ◽  
Marc Puyraveau ◽  
Maher Saleh ◽  
Philippe Gain ◽  
Isabelle Martinache ◽  
...  
Keyword(s):  
Penetrating Keratoplasty ◽  
Corneal Transplantation ◽  
Corneal Dystrophy ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Endothelial Keratoplasty ◽  
Surgical Indications ◽  
Anterior Lamellar Keratoplasty ◽  
Important Shift

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.

scholarly journals Malapposition of Graft-host Interface after Penetrating Keratoplasty (PK) and Deep Anterior lamellar Keratoplasty (DALK): an optical coherence tomography study

2019 ◽  
Author(s):  
Yujin Zhao ◽  
Hong Zhuang ◽  
Jiaxu Hong ◽  
Lijia Tian ◽  
Jianjiang Xu
Keyword(s):  
Optical Coherence Tomography ◽  
Penetrating Keratoplasty ◽  
Linear Regression Analysis ◽  
Corneal Transplantation ◽  
Anterior Segment ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Optical Coherence ◽  
Visual Outcomes ◽  
Anterior Lamellar Keratoplasty

Abstract Backgroud: Previous studies of internal graft-host malappositions have not dealt with the precise ways in which each malapposition affected post-penetrating keratoplasty (post-PK) visual outcomes. In this study, we reviewed our post-PK and post-deep anterior lamellar keratoplasty (post-DALK) keratoconic patients and used anterior segment optical coherence tomography (AS-OCT) to evaluate the associations between graft-host interface (GHI) characteristics and visual outcomes. Methods: Novel GHI metrics included: mean graft-host touch (GHT), total prevalence of malapposition proportion (Pm), frequency of apposition (F), size of malapposition (Sm), junctional graft thickness (Tg),junctional host thickness (Th) and the absolute value of difference between Tg and Th (|Tg-Th|). We connected the external and internal junction points of GHI (GHT) and drew a straight line through the central point, perpendicular to both sides of the cornea. Tg and Th were the thicknesses at cross-points 1 mm away from the meeting point on the external side of the graft and host, respectively. Linear regression analysis was used to describe associations between GHI metrics and postsurgical visual outcomes [ logarithm of minimum angle of resolution best-corrected visual acuity (logMAR BCVA), spherical equivalent diopter (SE), diopter of spherical power (DS), diopter of cylindrical power (DC) and keratometric astigmatism (Astig value)]. Results: We enrolled 22 post-PK and 23 post-DALK keratoconic patients. Compared with the regular-apposition results, GHT was decreased in step and gape patterns, and increased in hill and tag patterns. SE increased averagely by 6.851, 5.428 and 5.164 diopter per 1% increase in: F (step) [β=6.851; 95% Confidence interval (CI)=2.975-10.727; P=0.001]; F (graft step) [β=5.428; 95% CI=1.685-9.171; P=0.005]; and Pm [β=5.164; 95%CI=0.913-9.146; P=0.018], respectively. SE increased averagely by 0.31 diopter per 10-μm increment in |Tg-Th| [β=0.031; 95% CI=0.009-0.054; P=0.007]. LogMAR BCVA increased (on average) by 0.01 per 10-μm increment in both GHT [β=0.001; 95% CI=0-0.002; P=0.030]. and Tg [β=0.001; 95% CI=0.001-0.002; P=0.001]. Astig value increased on average by 0.17 diopter per 10-μm increment in Sm [β=0.017; 95% CI=0-0.033; P=0.047]. Conclusion: This investigation of GHI characteristics suggests explanations for varied ametropia in keratoconic eyes and has potential significance as a reference for promoting pre-surgical planning and technology for corneal transplantation.

scholarly journals Interface infectious keratitis after anterior and posterior lamellar keratoplasty. Clinical features and treatment strategies. A review

2018 ◽  
Vol 103 (3) ◽  
pp. 307-314 ◽  
Author(s):  
Luigi Fontana ◽  
Antonio Moramarco ◽  
Erika Mandarà ◽  
Giuseppe Russello ◽  
Alfonso Iovieno
Keyword(s):  
Penetrating Keratoplasty ◽  
Treatment Strategies ◽  
Virtual Space ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Infectious Keratitis ◽  
Endothelial Keratoplasty ◽  
Corneal Infection ◽  
Anterior Lamellar Keratoplasty ◽  
Sight Loss

Interface infectious keratitis (IIK) is a novel corneal infection that may develop after any type of lamellar keratoplasty. Onset of infection occurs in the virtual space between the graft and the host where it may remain localised until spreading with possible risk of endophthalmitis. A literature review identified 42 cases of IIK. Thirty-one of them occurred after endothelial keratoplasty and 12 after deep anterior lamellar keratoplasty. Fungi in the form of Candida species were the most common microorganisms involved, with donor to host transmission of infection documented in the majority of cases. Donor rim cultures were useful to address the infectious microorganisms within few days after surgery. Due to the sequestered site of infection, medical treatment, using both topical and systemic antimicrobials drugs, was ineffective on halting the progression of the infection. Injection of antifungals, right at the graft–host interface, was reported successful in some cases. Spreading of the infection with development of endophthalmitis occurred in five cases after Descemet stripping automated endothelial keratoplasty with severe sight loss in three cases. Early excisional penetrating keratoplasty showed to be the treatment with the highest therapeutic efficacy, lowest rate of complications and greater visual outcomes.

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