Free Papers

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

Free Paper Details

First Author: K.Iselin IRELAND

Co Author(s):    E. Greenan   W. Power   B. Quill   C. Murphy           

Abstract Details

Purpose:

To provide the first Irish National Corneal Transplant Registry report on current corneal transplantation practices in Ireland and to compare these practices with those of other developed countries.

Setting:

Irish National Corneal Transplant Registry

Methods:

Retrospective analysis of the Irish National Corneal Transplant Registry database from 2016 to 2019 in which data were recorded prospectively. Descriptive and statistical analysis was undertaken and then results compared to other such international standards.

Results:

Overall, 536 keratoplasties were carried out; 256 (61%) 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). Most common indications were Keratoconus (KC; 19%), Fuchs Endothelial Dystrophy (FED; 18.8%) and Pseudophakic Bullous Keratopathy (PBK; 16.9%). KC (34%) and re-grafting (17%) were leading indications for PK, and FED and PBK for DSAEK (39% and 33%) and DMEK (67% and 20%). PK numbers remained stable, whereas Endothelial Keratoplasties increased (3.8 to 5.6 and 0.2 to 1.6 per month), becoming the most commonly performed grafts since 2018

Conclusions:

Corneal transplantation in Ireland is following international trends. Endothelial procedures have become the most frequented approach since 2018, as the number of DMEK and DALK procedures are only starting to become popular. Furthermore, the number of transplant procedures performed in Ireland increased over the study period. However, this number is still low when compared with other developed countries suggesting that not all suitable patients are accessing this treatment at an appropriate time. Therefore, care pathways to improve access to corneal transplantation should be developed.

Financial Disclosure:

-