Practice patterns and long-term outcomes of corneal transplantation for infectious keratitis: a Dutch registry study

Session Details

Session Title: Presented Poster Session: Spotlight on Cornea

Venue: Poster Village: Pod 2

First Author: : M.Dickman THE NETHERLANDS

Co Author(s): :    S. Dunker   S. Tang   B. Winkens   R. Nuijts              

Abstract Details

Purpose:

To evaluate the practice patterns and outcomes of corneal transplantation for infections keratitis in the Netherlands.

Setting:

Netherlands National organ transplant registry (NOTR).

Methods:

Using the NOTR, all consecutive corneal transplantations for infectious keratitis were analyzed between 8th December, 2006 and 17th December, 2017. The primary outcome measure was graft survival.

Results:

In total 975 primary transplants were performed. The main pathogens were (n/%): viral (450/46%), bacterial (275/28%), parasitic (122/13%) and fungal (53/5%). Overall graft survival measured: 97% (3months), 95% (6months), 91% (one-year), 86% (two-years), 79% (five-years) and 51% (ten years). Graft survival was significantly worse in acanthamoeba (5-year hazard ratio (HR) compared to viral keratitis 3.4, p<0.001) and emergency grafts (5-year HR 3.2, p<0.001). HLA-matched keratoplasty (5-year HR 0.4, P=0.114) and Deep Anterior Lamellar Keratoplasty (DALK, 5-year HR 0.744, p=0.744) provided no significant survival benefit compared to non HLA-matched grafts and PKP, respectively.

Conclusions:

The number of corneal transplantations for infectious keratitis in the Netherlands remained stable the last decade. The leading pathogens were Herpes Simplex and bacterial infections. Overall graft survival was high in the first year, decreasing significantly thereafter. Graft survival was significantly lower for acanthamoeba and emergency grafts, independent of pathogen. HLA-matched transplants and DALK provided no significant survival benefit for infectious keratitis.

Financial Disclosure:

None