Three decades of corneal transplantation: Indications and patient characteristics

Purpose. To review the indications and patient characteristics for penetrat ing keratoplasty (PKP). Methods. Retrospective review of records at the Pat hology Service, Department of Ophthalmology, University of Toronto from 196 4 to 1997. Results. The 6,222 records were reviewed. The leading indication s for PKP were regraft, keratoconus (KC), pseudophakic bullous keratopathy (PBK), Fuchs' dystrophy, viral infections, and trauma, in that order. Durin g the second half of the 1980s, PBK replaced KC as the leading indication f or transplantation. The average age of patients increased from 49 (+/-19) y ears during the second half of the 1960s to 63 (+/-20) years at the first h alf of the 1990s. Gender differences (M/F ratio) were significant for KC, v iral keratopathy, trauma, PBK, aphakic bullous keratopathy (ABK), edema of unspecified etiology, interstitial keratitis, rheumatoid arthritis, and Fuc hs' dystrophy. Diagnostic category differences between all patients for PKP s and regrafts were significant for autoimmune keratolysis, congenital opac ities, PBK, ABK, edema of unspecified etiology, scarring, Fuchs' dystrophy, and KC. Conclusion. Indications are in accordance with the literature with the exception of regraft, which was higher. An increase in the average age of patients corresponded with the PBK epidemic. The high male-to-female ra tio among patients with KC was different from that previously reported for the prevalence of this condition. Sex distribution among patients with PBK and ABK showed a female predominance. Differences in the underlying disease distributions between regrafted patients and the rest of the series coinci de with prognostic classifications for PKP.