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Changing trends in corneal transplantation: a national review of current practices in the Republic of Ireland

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Abstract

Background

First Irish National Corneal Transplant Registry report.

Aim

To report about current corneal transplantation practices in Ireland including patient demographics, indications and types of transplant performed and to compare the findings with other developed countries.

Methods

Nationwide retrospective review of the corneal transplants performed in Ireland between 2016 and 2019.

Results

Overall, 536 keratoplasties were carried out: 256 (47.8%) Penetrating Keratoplasties (PK), 212 (39.6%) Descemet Stripping Automated Endothelial Keratoplasties (DSAEK), 30 (5.6%) Descemet Membrane Endothelial Keratoplasties (DMEK), and 25 (4.7%) Deep Anterior Lamellar Keratoplasties (DALK). The most common indication was Keratoconus (KC, 19%), followed by Fuchs endothelial dystrophy (FED, 18.8%), and Pseudophakic bullous keratopathy (PBK, 17%). KC (34%) and re-grafting (17%) were the leading indications for PK, whereas FED and PBK were the major indications for DSAEK (38% and 33%) and DMEK (67% and 20%), respectively. During the period studied, the number of transplants increased from 11.3 to 14 grafts per month. The number of PKs remained stable, whereas Endothelial Keratoplasties, DSAEK and DMEK, increased (3.8 to 5.6 and 0.2 to 1.6 per month, respectively), becoming the most commonly performed grafts since 2018. Only a small number of DALK were performed.

Conclusions

Corneal transplantation in Ireland is following international trends as endothelial procedures have become the most common approach since 2018. However, a low overall number of transplants is performed in Ireland compared with other countries suggesting that care pathways should be implemented to improve access to corneal transplantation.

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Data availability

All data were provided by the Irish Blood and Transfusion Service in an anonymous way.

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Author information

Authors and Affiliations

  1. Royal Victoria Eye and Ear Hospital, Dublin 2, Ireland

    Katja C. Iselin, Emily Greenan, William J. Power, Barry Quill & Conor C. Murphy

  2. RCSI University of Medicine and Health Sciences, Dublin 2, Ireland

    Katja C. Iselin, Emily Greenan & Conor C. Murphy

  3. National Eye Bank, Irish Blood Transfusion Service, St James’ Hospital, Dublin 8, Ireland

    Colin Hynes & Sandra Shaw

  4. Mater Misericordiae University Hospital, Dublin 7, Ireland

    Tim Fulcher & Marc Guerin

  5. Hermitage Medical Clinic, Dublin, Ireland

    Weng H. Lee

Authors
  1. Katja C. Iselin
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  2. Emily Greenan
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  6. William J. Power
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  10. Conor C. Murphy
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Katja C Iselin, Emily Greenan, Colin Hynes, Sandra Shaw, Tim Fulcher, William J Power, Barry Quill, Marc Guerin, Weng H Lee, and Conor C Murphy. The first draft of the manuscript was written by Katja C Iselin, Conor C Murphy and Emily Greenan and all authors commented on previous versions of the manuscript.

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Correspondence to Katja C. Iselin.

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We are aware of our obligations under the data protection legislation and we have taken the necessary measures to ensure that the data used in this report have been fully anonymized. Given the additional safety and security measures taken in addition to Good Clinical Practice ethics approval is not required.

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Iselin, K.C., Greenan, E., Hynes, C. et al. Changing trends in corneal transplantation: a national review of current practices in the Republic of Ireland. Ir J Med Sci 190, 825–834 (2021). https://doi.org/10.1007/s11845-020-02340-1

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  • DOI: https://doi.org/10.1007/s11845-020-02340-1

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