Corneal Transplantation in New Zealand 2000 to 2009

Abstract

In this study of 941 consecutive, principally penetrating, corneal transplants, adverse events were found to be more common than typically reported. In an era in which PKP is increasingly substituted by lamellar surgery, this provides useful insight into operative and postoperative adverse events in penetrating surgery.

Repeat corneal transplantation in Auckland, New Zealand: Indications, visual outcomes and risk factors for repeat keratoplasty failure

“…Ethnicity, rejection and graft failure appear to be interlinked in the results from this study and it is difficult to separate the three. Corneal allograft rejection was the leading cause of PK graft failure in a previous Auckland study, and ethnicity was found to be a significant risk factor for graft rejection on multivariate analysis . A further study from the same group found that Maori and Pacific Island ethnicities were observed to have the lowest level of follow‐up attendance following corneal transplant .…”

“…Corneal allograft rejection was the leading cause of PK graft failure in a previous Auckland study, and ethnicity was found to be a significant risk factor for graft rejection on multivariate analysis. 16 A further study from the same group found that Maori and Pacific Island ethnicities were observed to have the lowest level of follow-up attendance following corneal transplant. 29 The authors did not find a statistically significant correlation between appointment attendance and subsequent graft failure; however, they acknowledged that the lower attendance rate may cause under-detection of graft failure.…”

“…This is not surprising given the increasing longevity of the population, the limited survival expectancy of corneal grafts, and the development of new surgical transplant techniques. The impact of limited survival of penetrating keratoplasty (PK) beyond 25 to 30 years is particularly relevant in New Zealand where many transplants are performed in relatively young patients with keratoconus …”

“…The impact of limited survival of penetrating keratoplasty (PK) beyond 25 to 30 years is particularly relevant in New Zealand where many transplants are performed in relatively young patients with keratoconus. 16,17 It has been well recognized that repeat corneal transplants have poorer survival rates compared with first keratoplasty procedures, and that the survival rate further decreases with each successive transplant. 13,14,18,19 This has implications for patients as well as hospital and eye bank resources given the limited supply of donor corneas.…”

Conserving, restoring and replacing the human corneal endothelium in 2020: is a clear future here today?

“…Nonetheless, the most common cause of corneal allograft failure remains cell‐mediated rejection . In addition to allograft rejection, penetrating keratoplasty is also associated with significant ametropia, astigmatism and common complications related to corneal sutures …”