Current Perspectives on Corneal Transplantation

Overview

Journal Clin Ophthalmol

Publisher Dove Medical Press

Specialty Ophthalmology

Date 2022 Mar 14

PMID 35282172

Authors

Siyin Liu

Yee Ling Wong

Andrew Walkden

Affiliations

Soon will be listed here.

Abstract

Disease of the cornea is the third leading cause of blindness worldwide. Corneal graft surgery is one of the most successful forms of solid organ transplantations in humans, with ever-increasing developments in surgical technique. To date, approximately 4504 corneal transplants are performed in the United Kingdom each year. While full thickness transplantation was the most commonly performed keratoplasty over the last few decades, selective lamellar transplantation of the diseased layers of the cornea has been universally adopted. This comprehensive review aims to provide an updated synthesis on different types of corneal transplantations, their treatment outcomes, and the associated complications of each procedure in both adult and paediatric population. In addition, we also present an up-to-date summary of the emerging therapeutic approaches that have the potential to reduce the demand for donor-dependent keratoplasty.

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References

Feizi S, Javadi M . Effect of Donor Graft Thickness on Clinical Outcomes after Descemet Stripping Automated Endothelial Keratoplasty. J Ophthalmic Vis Res. 2019; 14(1):18-26. PMC: 6388529. DOI: 10.4103/jovr.jovr_55_17. View

Price M, Price Jr F, Kruse F, Bachmann B, Tourtas T . Randomized comparison of topical prednisolone acetate 1% versus fluorometholone 0.1% in the first year after descemet membrane endothelial keratoplasty. Cornea. 2014; 33(9):880-6. DOI: 10.1097/ICO.0000000000000206. View

Haddadin R, Chodosh J . Corneal transplantation and glaucoma. Semin Ophthalmol. 2014; 29(5-6):380-96. DOI: 10.3109/08820538.2014.959201. View

Baydoun L, van Dijk K, Dapena I, Musa F, Liarakos V, Ham L . Repeat Descemet membrane endothelial keratoplasty after complicated primary Descemet membrane endothelial keratoplasty. Ophthalmology. 2014; 122(1):8-16. DOI: 10.1016/j.ophtha.2014.07.024. View

Price M, Giebel A, Fairchild K, Price Jr F . Descemet's membrane endothelial keratoplasty: prospective multicenter study of visual and refractive outcomes and endothelial survival. Ophthalmology. 2009; 116(12):2361-8. DOI: 10.1016/j.ophtha.2009.07.010. View

Janson B, Alward W, Kwon Y, Bettis D, Fingert J, Provencher L . Glaucoma-associated corneal endothelial cell damage: A review. Surv Ophthalmol. 2017; 63(4):500-506. DOI: 10.1016/j.survophthal.2017.11.002. View

Zhang A, Rubenstein D, Price A, Cote E, Levitt M, Sharpen L . Evolving surgical techniques of and indications for corneal transplantation in Ontario: 2000 - 2012. Can J Ophthalmol. 2013; 48(3):153-9. DOI: 10.1016/j.jcjo.2012.12.008. View

Hos D, Tuac O, Schaub F, Stanzel T, Schrittenlocher S, Hellmich M . Incidence and Clinical Course of Immune Reactions after Descemet Membrane Endothelial Keratoplasty: Retrospective Analysis of 1000 Consecutive Eyes. Ophthalmology. 2017; 124(4):512-518. DOI: 10.1016/j.ophtha.2016.12.017. View

Rodriguez-Calvo de Mora M, Groeneveld-van Beek E, Frank L, Wees J, Oellerich S, Bruinsma M . Association Between Graft Storage Time and Donor Age With Endothelial Cell Density and Graft Adherence After Descemet Membrane Endothelial Keratoplasty. JAMA Ophthalmol. 2015; 134(1):91-4. DOI: 10.1001/jamaophthalmol.2015.4499. View

10.

Cotsarelis G, Cheng S, Dong G, Sun T, Lavker R . Existence of slow-cycling limbal epithelial basal cells that can be preferentially stimulated to proliferate: implications on epithelial stem cells. Cell. 1989; 57(2):201-9. DOI: 10.1016/0092-8674(89)90958-6. View

11.

Song Y, Zhang J, Pan Z . Systematic Review and Meta-Analysis of Clinical Outcomes of Penetrating Keratoplasty Versus Deep Anterior Lamellar Keratoplasty for Keratoconus. Exp Clin Transplant. 2019; 18(4):417-428. DOI: 10.6002/ect.2019.0123. View

12.

Kelly T, Williams K, Coster D . Corneal transplantation for keratoconus: a registry study. Arch Ophthalmol. 2011; 129(6):691-7. DOI: 10.1001/archophthalmol.2011.7. View

13.

Anwar M, Teichmann K . Deep lamellar keratoplasty: surgical techniques for anterior lamellar keratoplasty with and without baring of Descemet's membrane. Cornea. 2002; 21(4):374-83. DOI: 10.1097/00003226-200205000-00009. View

14.

Borderie V, Boelle P, Touzeau O, Allouch C, Boutboul S, Laroche L . Predicted long-term outcome of corneal transplantation. Ophthalmology. 2009; 116(12):2354-60. DOI: 10.1016/j.ophtha.2009.05.009. View

15.

Ang M, Soh Y, Htoon H, Mehta J, Tan D . Five-Year Graft Survival Comparing Descemet Stripping Automated Endothelial Keratoplasty and Penetrating Keratoplasty. Ophthalmology. 2016; 123(8):1646-1652. DOI: 10.1016/j.ophtha.2016.04.049. View

16.

Maier A, Klamann M, Torun N, Gonnermann J, Schroeter J, Joussen A . Intraocular pressure elevation and post-DSEK glaucoma after Descemet`s stripping endothelial keratoplasty. Graefes Arch Clin Exp Ophthalmol. 2012; 251(4):1191-8. DOI: 10.1007/s00417-012-2203-5. View

17.

Vajpayee R, Sharma N, Sinha R, Agarwal T, Singhvi A . Infectious keratitis following keratoplasty. Surv Ophthalmol. 2007; 52(1):1-12. DOI: 10.1016/j.survophthal.2006.10.001. View

18.

Arya S, Raj A, Bamotra R, Bhatti A, Deswal J, Sindhu M . Indications and graft survival analysis in optical penetrating keratoplasty in a tertiary care center in North India: a 5-year study. Int Ophthalmol. 2017; 38(4):1669-1679. DOI: 10.1007/s10792-017-0641-0. View

19.

Anshu A, Price M, Price F . Descemet's stripping endothelial keratoplasty: long-term graft survival and risk factors for failure in eyes with preexisting glaucoma. Ophthalmology. 2012; 119(10):1982-7. DOI: 10.1016/j.ophtha.2012.04.031. View

20.

Castellucci M, Novara C, Casuccio A, Cillino G, Giordano C, Failla V . Bilateral Ultrathin Descemet's Stripping Automated Endothelial Keratoplasty vs. Bilateral Penetrating Keratoplasty in Fuchs' Dystrophy: Corneal Higher-Order Aberrations, Contrast Sensitivity and Quality of Life. Medicina (Kaunas). 2021; 57(2). PMC: 7913208. DOI: 10.3390/medicina57020133. View