Emergency corneal grafting in the United Kingdom: a 6 year analysis of the UK transplant registry

Session Details

Session Title: Cornea Surgical II

Session Date/Time: Tuesday 13/09/2016 | 08:00-10:30

Paper Time: 09:04

Venue: Hall C2

First Author: : A.Tourkmani UK

Co Author(s): :    P. Hossain   M. Tsatsos   M. Jones   D. Anderson           

Abstract Details

Purpose:

To show the 6 year follow up results of emergency corneal graft (eCG) in the United Kingdom.

Setting:

All corneal grafts registered by the United Kingdom Transplant Service from April 1999 to March 2005

Methods:

Retrospective, multifactorial analysis. eCG was classified by using ‘reasons for grafts’: therapeutic (severe infection, threatened or actual perforation) as selected by the surgeons on the United Kingdom Transplant Audit form.

Results:

A total of 12976 CGs were performed, 1330 (11.4%) of which were done under emergency circumstances including 433 re-grafts. Actual perforation occurred in 876(65.9%) patients of which 420(31.5%) were grafted for tectonic purposes alone and 217(16.3%) were also grafted for visual rehabilitation. The main diagnostic categories were infection(39.4%), ulcerative keratitis(32.2%) and other (ectasias 7%, previous ocular surgery 5.7%, injury 4.1%, dystrophies 2.6% and opacification 1.9%). The overall graft survival of first eCG at one, two and five years were 78%, 66% and 47% respectively. The vision of the surviving grafts was: 6/12 or better in 29.9%, 6/18 to 6/60 in 38.4%, CF to LP in 30.6% and NPL in 1% with worsening of vision in only 8.7% of the patients.

Conclusions:

This is the largest study of its kind and shows that despite the severity of the underlying conditions & the surgical challenges that they pose, the outcomes of eCG are favourable with most patients maintaining useful vision & avoiding immediate rejection. This emphasises the importance of eye banking facilities in the supply of high quality corneal tissue for emergency keratoplasty.

Financial Disclosure:

NONE