Trends in indications and techniques of corneal transplantation in Iran from 2006 to 2013; An 8-year review

Purpose: to report changing trends in indications and techniques of corneal transplantation in iran. methods: we reviewed eye bank records of 47,129 patients who had undergone corneal transplantation between 2006 and 2013 at different eye centers throughout iran. results: the most common indication for corneal transplantation was keratoconus (kcn,n = 21,350 eyes,45.3%),followed by bullous keratopathy (bk,n = 8,566 eyes,18.2%),corneal opacity and scar (cos,n = 7,158 eyes,15.2%),graft failure (n = 3,252 eyes,6.9%),corneal dystrophies (n = 2,553 eyes,5.4%),and infectious keratitis (n = 2,238 eyes,4.7%). over the study period,there was a significant increase in the frequency of bk (p = 0.001) and graft failure (p = 0.025),and a significant decrease in the relative frequency of cos (p = 0.012). the prevalence of kcn (p = 0.172),infectious keratitis (p = 0.107),and corneal dystrophies (p = 0.836) remained unchanged. the most common technique of corneal transplantation was penetrating keratoplasty (pkp,n = 33,476 eyes,71.0%),followed by deep anterior lamellar keratoplasty (dalk,n = 8,363 eyes,17.7%),descemet's stripping automated endothelial keratoplasty (dsaek,n = 3,516 eyes,7.5%),tectonic (n = 1752,3.7%),and keratolimbal allograft (klal,n = 19 eyes,0.1%). regarding the shift in surgical techniques,a significant increase was observed in dsaek (p < 0.001),whereas pkp was significantly decreased (p = 0.005) over the 8-year period. no significant change was seen in the rates of dalk (p = 0.354),tectonic graft (p < 0.999) and klal (p = 0.151). conclusion: kcn was the most common indication and pkp was the most prevalent technique used for corneal transplantation. significant changes in surgical techniques were observed over the past 8 years; dsaek demonstrated an increasing trend while pkp showed a decrease. © 2016 journal of ophthalmic and vision research.