J Cataract Refract Surg 2021 Jan 11. Epub 2021 Jan 11.
1 University Eye Clinic, Maastricht University Medical Center+, The Netherlands. 2 Translational Health Sciences, University of Bristol, UK. 3 Tissue and Eye Services, NHS Blood and Transplant, Bristol, UK. 4 European Eye Bank Association (EEBA), Venice, Italy. 5 Department of Ophthalmology, Sahlgrenska University Hospital, Gothenburg, Sweden. 6 European Society of Cataract and Refractive Surgeons (ESCRS), Dublin, Ireland. 7 Department of Ophthalmology, Royal Victoria Infirmary and Newcastle University, Newcastle upon Tyne, UK. 8 Dutch Transplant Foundation, Leiden, The Netherlands. 9 Department of Ophthalmology, Aarhus University Hospital, Denmark. 10 European Society of Cornea and Ocular Surface Disease Specialists (EuCornea), Dublin, Ireland. 11 The Veneto Eye Bank Foundation, Venice, Italy. 12 Department of Clinical Sciences, Ophthalmology, Faculty of Medicine, Lund University, Lund, Sweden.
Purpose: To report practice patterns of corneal transplantation in Europe.
Setting: Corneal clinics in ten European member states, the United Kingdom, and Switzerland.
Design: Multinational registry study.
Methods: Corneal transplant procedures registered in the European Cornea and Cell Transplantation Registry (ECCTR) were identified. We analyzed preoperative donor and recipient characteristics, indication and reason for transplantation, and surgical techniques.
Results: 12,913 corneal transplants were identified from ten European Union member states, the United Kingdom (UK) and Switzerland. Most countries were self-sufficient with regard to donor tissue. Fuchs' endothelial corneal dystrophy (FED) was the most common indication (41%, n=5,325), followed by regraft (16%, n=2,108), Pseudophakic bullous keratopathy (PBK, 12%, n=1,594), and keratoconus (12%, n=1,506). Descemet stripping (automated) endothelial keratoplasty (DS[A]EK, 46%, n=5,918) was the most commonly performed technique, followed by Penetrating keratoplasty (PK, 30%, n=3,886), and Descemet membrane endothelial keratoplasty (DMEK, 9%, n=1,838). Vision improvement was the main reason for corneal transplantation (90%, n=11,591). Surgical technique and reason for transplantation differed between indications.
Conclusions: This report provides the most comprehensive overview of corneal transplantation practice patterns in Europe to date. Fuchs endothelial dystrophy is the most common indication, vision improvement the leading reason, and DS(A)EK the predominant technique for corneal transplantation.