Indications for and techniques of keratoplasty at Vietnam National Institute of Ophthalmology

AIM： To report the indications for and techniques of corneal transplantation at Vietnam National Institute of Ophthalmology （VNIO） over a period of 12y （2002-2013）, METHODS： Records of patients who had undergone corneal transplantation at VNIO from January 1, 2002 to January 1, 2014 were reviewed to determine the indication for and type of corneal transplant performed. Patient age, gender, indication for corneal transplantation and surgical technique were recorded and analyzed. RESULTS： Corneal transplantation were underwent in 1390 eyes of 1278 patients with a mean age of 44.9±18.1y during the period under review. The most common indication was infectious corneal ulcer （n=670; 48.2%）, followed by corneal scar （n=333, 24.0% ）, corneal dystrophy （n=138, 9.9%） and failed graft （n=112, 8.1%）. Nearly all procedures performed were penetrating keratoplasty （n=1300, 93.5% ）, with a few lamellar keratoplasty procedures performed： lamellar keratoplasty （n=52, 3.7%）, Descemet＇s stripping automated endothelial keratoplasty （n =27, 1.9% ） and deep anterior lamellar keratoplasty （n =11, 0.8%）.CONCLUSION： While the most common indication for keratoplasty was infectious keratitis, nearly all indications for corneal transplantation were managed with penetrating keratoplasty, However, lamellar keratoplasty techniques, including deep anterior lamellar keratoplasty and Descemet＇s stripping automated endothelial keratoplasty, are being performed with increasing frequency for isolated stromal and endothelial disorders, respectively,

Changing trends in corneal graft surgery： a ten-year review

AIM：To review indications and corneal tissue use for penetrating and lamellar surgery between 2002 and 2011.·METHODS：The surgical reports of corneal grafts performed during 2002-2011,using tissues supplied by the Eye Bank of Piedmont（Italy）,were reviewed retrospectively.Patient demographic data,date of intervention,indication for surgery,and surgical technique used were recorded.Surgical techniques included penetrating keratoplasty（PK）,deep anterior lamellar keratoplasty（DALK）and endothelial keratoplasty（EK）.The2test was used to compare the distribution of indications and types of surgical technique used,for corneal grafts done during 2002-2006 versus those done during 2007-2011.·RESULTS：The number of corneal grafts increased by30.7%from 2002-2006 to 2007-2011（from 1567 to 2048）.Comparing the two periods,both main indications and surgical techniques changed significantly.In 2007-2011,the proportion of interventions for aphakic/pseudophakic bollous keratopathy（from 16.8%to 21.3%）,graft failure（from 16.4%to 19.1%）and Fuchs endothelial dystrophy（from 12.8%to 16.7%）all increased significantly（〈0.05）,while those for keratoconus decreased significantly（from35.6%to 27.3%;〈0.001）.In 2007-2011,the proportion of PK decreased significantly（from 92.4%to 57.2%;〈0.001）while that of EK and DALK went from 0.4%to48 30.2%（〈0.001）and from 7.2%to 12.6%（〈0.001）respectively.·CONCLUSION：During 2002-2011 the number of interventions increased significantly for corneal endothelial diseases and graft failure.The growing demand for interventions for these diseases corresponded to the widespread adoption of EK techniques.The use of DALK also increased,but more moderately than EK procedures.