Abstract
Purpose
To evaluate the indications for corneal transplantation, the procedures carried out, and the postoperative outcomes and to compare these with previous Irish corneal transplant studies.
Methods
A retrospective review of the case notes of all patients who underwent corneal transplantation under the care of a single surgeon, from 2008 to 2015, was performed. The risk factors for postoperative complications including transplant failure were examined.
Results
During the period studied, 42 corneal transplant surgeries were carried out on 40 eyes of 38 patients, 24 of whom were male (63%), median age at surgery was 62 years (range 23–96 years). The most common indication for transplantation was pseudophakic corneal decompensation associated with Fuch’s endothelial dystrophy (FED) (n = 13). Seventeen penetrating keratoplasties, 23 lamellar keratoplasties, and two amniotic membrane transplant procedures were carried out. Transplant failure resulting in corneal oedema or repeat corneal transplant surgery (n = 4, 10%), was associated with previous transplant failure in the eye; odds ratio (OR) = 1.58 (p = 0.05), and with comorbid FED, OR = 1.50 (p = 0.02). Intraocular lens opacification occurred in one lens following DSAEK, giving an incidence rate of 7%.
Conclusions
Pseudophakic corneal decompensation is the commonest indication for corneal transplant surgery, with lamellar keratoplasty the most frequent approach in our cohort, reflecting developments observed in corneal transplant surgery elsewhere. Prior corneal transplant failure and Fuch’s dystrophy remain important risk factors for failure. The risk of intraocular lens opacification and its potential effects on vision should be elaborated prior to endothelial keratoplasty.
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References
Melles GR, Eggink FA, Lander F et al (1998) A surgical technique for posterior lamellar keratoplasty. Cornea 17(6):618–626
Park CY, Lee JK, Gore PK, Lim CY, Chuck RS (2015) Keratoplasty in the United States: a 10-year review from 2005 through 2014. Ophthalmology 122(12):2432–2442
Price FW Jr, Feng MT, Price MO (2015) Evolution of endothelial Keratoplasty: where are we headed? Cornea 34(Suppl 10):S41–S47
Croasdale CR, Barney E, Warner EJ (2013) Eye bank tissue utilization between endothelial keratoplasty and penetrating keratoplasty. Cornea 32(3):280–284
Bahar I, Kaiserman I, Levinger E, Sansanayudh W, Slomovic AR, Rootman DS (2009) Retrospective contralateral study comparing descemet stripping automated endothelial keratoplasty with penetrating keratoplasty. Cornea 28(5):485–488
Price MO, Gorovoy M, Benetz BA et al (2010) Descemet’s stripping automated endothelial keratoplasty outcomes compared with penetrating keratoplasty from the cornea donor study. Ophthalmology 117(3):438–444
Tan DT, Dart JK, Holland EJ, Kinoshita S (2012) Corneal transplantation. Lancet 379(9827):1749–1761
Khan MI, Muhtaseb M (2011) Opacification of the intraocular lens implant following uneventful Descemet’s stripping endothelial keratoplasty. Cont Lens Anterior Eye 34(2):92–93
Werner L, Apple DJ, Kaskaloglu M, Pandey SK (2001) Dense opacification of the optical component of a hydrophilic acrylic intraocular lens: a clinicopathological analysis of 9 explanted lenses. J Cataract Refract Surg 27(9):1485–1492
Ahad MA, Darcy K, Cook SD, Tole DM (2014) Intraocular lens opacification after descemet stripping automated endothelial keratoplasty. Cornea 33(12):1307–1311
Nieuwendaal CP, van der Meulen IJ, Patryn EK, Werner L, Mourits MP, Lapid-Gortzak R (2015) Opacification of the intraocular lens after Descemet stripping endothelial keratoplasty. Cornea 34(11):1375–1377
Patryn E, van der Meulen IJ, Lapid-Gortzak R, Mourits M, Nieuwendaal CP (2012) Intraocular lens opacifications in Descemet stripping endothelial keratoplasty patients. Cornea 31(10):1189–1192
Dhital A, Spalton DJ, Goyal S, Werner L (2012) Calcification in hydrophilic intraocular lenses associated with injection of intraocular gas. Am J Ophthalmol 153(6):1154–1160 e1151
Fellman MA, Werner L, Liu ET et al (2013) Calcification of a hydrophilic acrylic intraocular lens after Descemet-stripping endothelial keratoplasty: case report and laboratory analyses. J Cataract Refract Surg 39(5):799–803
Neuhann IM, Neuhann TF, Rohrbach JM (2013) Intraocular lens calcification after keratoplasty. Cornea 32(4):e6–10
Ni Mhealoid A, Fulcher T, O’Keefe M (2015) Anterior surface opacification of intraocular lenses after Descemet's stripping automated endothelial keratoplasty. BMJ Case Rep 2015:bcr2015213216
Schmidinger G, Pemp B, Werner L (2013) Opacification of an intraocular lens: calcification of hydrophilic intraocular lenses after gas tamponade of the anterior chamber. Ophthalmologe 110(11):1066–1068
Werner L, Wilbanks G, Ollerton A, Michelson J (2012) Localized calcification of hydrophilic acrylic intraocular lenses in association with intracameral injection of gas. J Cataract Refract Surg 38(4):720–721
MacLean KD, Apel A, Wilson J, Werner L (2015) Calcification of hydrophilic acrylic intraocular lenses associated with intracameral air injection following DMEK. J Cataract Refract Surg 41(6):1310–1314
Mojzis P, Studeny P, Werner L, Pinero DP (2016) Opacification of a hydrophilic acrylic intraocular lens with a hydrophobic surface after air injection in Descemet-stripping automated endothelial keratoplasty in a patient with Fuchs dystrophy. J Cataract Refract Surg 42(3):485–488
Guerin M, O’Connell E, Walsh C, Fulcher T (2008) Visual outcomes and graft survival following corneal transplants: the need for an Irish National Corneal Transplant Registry. Ir J Med Sci 177(2):107–110
Keenan TD, Jones MN, Rushton S et al (2012) Trends in the indications for corneal graft surgery in the United Kingdom: 1999 through 2009. Arch Ophthalmol 130(5):621–628
Ghosheh FR, Cremona FA, Rapuano CJ et al (2008) Trends in penetrating keratoplasty in the United States 1980-2005. Int Ophthalmol 28(3):147–153
Matthaei M, Sandhaeger H, Hermel M et al (2016) Changing indications in penetrating keratoplasty: a systematic review of 34 years of global reporting. Transplantation. doi:10.1097/TP.0000000000001281
Kim BZ, Meyer JJ, Brookes NH et al (2016) New Zealand trends in corneal transplantation over the 25 years 1991-2015. Br J Ophthalmol. doi:10.1136/bjophthalmol-2016-309021
McGill P (2010) Illustrating ageing in Ireland north and south: key facts and figures. Belfast, Centre for Ageing Research and Development in Ireland
Godefrooij DA, Gans R, Imhof SM, Wisse RP (2016) Nationwide reduction in the number of corneal transplantations for keratoconus following the implementation of cross-linking. Acta Ophthalmol 94(7):675–678
de Sanctis U, Alovisi C, Bauchiero L et al (2016) Changing trends in corneal graft surgery: a ten-year review. Int J Ophthalmol 9(1):48–52
Cornea Donor Study Investigator G, gal RL, Dontchev M et al (2008) The effect of donor age on corneal transplantation outcome results of the cornea donor study. Ophthalmology 115(4):620–626 e626
Wacker K, Baratz KH, Maguire LJ, McLaren JW, Patel SV (2016) Descemet stripping endothelial keratoplasty for Fuchs’ endothelial corneal dystrophy: five-year results of a prospective study. Ophthalmology 123(1):154–160
Price MO, Fairchild KM, Price DA, Price FW Jr (2011) Descemet’s stripping endothelial keratoplasty five-year graft survival and endothelial cell loss. Ophthalmology 118(4):725–729
Coster DJ, Williams KA (2003) Management of high-risk corneal grafts. Eye (Lond) 17(8):996–1002
Brahma A, Ennis F, Harper R, Ridgway A, Tullo A (2000) Visual function after penetrating keratoplasty for keratoconus: a prospective longitudinal evaluation. Br J Ophthalmol 84(1):60–66
Lacey JC, Ghatora BK, Foot PJ, Barton SJ, De Cock R (2016) Intraocular lens calcification after DSEK: a mechanism and preventive technique. Cornea 35(9):e28–e30
Bompastor-Ramos P, Povoa J, Lobo C et al (2016) Late postoperative opacification of a hydrophilic-hydrophobic acrylic intraocular lens. J Cataract Refract Surg 42(9):1324–1331
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Quigley, C., McElnea, E. & Fahy, G. Trends in corneal transplant surgery in Ireland: indications and outcomes of corneal transplant surgery and intraocular lens opacification following Descemet’s stripping automated endothelial keratoplasty. Ir J Med Sci 187, 231–236 (2018). https://doi.org/10.1007/s11845-017-1605-0
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DOI: https://doi.org/10.1007/s11845-017-1605-0