CHANGING INDICATIONS FOR PENETRATING KERATOPLASTY - A NEWLY DEVELOPEDCOUNTRY EXPERIENCE

Purpose: To study the changing indications for penetrating keratoplast y in Singapore and compare local indications with developed countries with established corneal graft programs. Methods: A descriptive study of ail penetrating keratoplasty cases performed in the Singapore Natio nal Eye Center over a 5 year period, from 1 January 1991 to 31 Decembe r 1995 using records of the Singapore Eye Bank registry. Results: A to tal of 327 penetrating keratoplasties were performed. Bullous keratopa thy was the indication in more than a quarter of all cases (26.3%). Ap hakic bullous keratopathy (11.6%) and pseudophakic bullous keratopathy (11.3%) accounted for the majority of the bullous keratopathy cases. The other reading indications were: regrafts (11.9%), corneal dystroph ies (10.4%), traumatic scarring (10.1%) and keratoconus (9.8%). A high er proportion of aphakic and pseudophakic bullous keratopathy as well as regrafts was noted in this series, compared to a previous report on corneal transplantation in the 1980s. A rising indication rate of pse udophakic bullous keratopathy, in conjunction with a declining indicat ion rate of herpetic keratitis was observed over the 5 year study peri od. Conclusions: The indications for penetrating keratoplasty in Singa pore appear to follow the trend seen in developed Western countries ov er the past few decades.