Article Text

PDF
Emergency corneal grafting in the UK: a 6-year analysis of the UK Transplant Registry
  1. Parwez Hossain, Principle Investigator1,2,
  2. Abdo Karim Tourkmani2,
  3. Dimitri Kazakos1,
  4. Mark Jones3,
  5. David Anderson2
  6. On behalf of the NHS Blood and Transplant Ocular Tissue Advisory Group and Contributing Ophthalmologists
  1. 1 Academic Unit of Clinical Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, UK
  2. 2 Southampton Eye Unit, Southampton General Hospital, Southampton, UK
  3. 3 Statistics and Audit Directorate, NHS Blood and Transplant, Bristol, UK
  1. Correspondence to Dr Parwez Hossain, Eye Unit, MP104, University of Southampton, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK; parwez{at}soton.ac.uk

Abstract

Background Corneal graft (CG) surgery is the most common and successful tissue transplant worldwide. A small and important group of patients are operated in emergency situations, typically to save a perforated eye. Our knowledge of the indications and outcomes of emergency corneal graft (eCG) is limited.

Methods Retrospective, multifactorial analysis of all CGs registered by the UK Transplant Service from April 1999 to March 2005.

Results A total of 12 976 CGs were performed. 1330 (11.4%) were eCGs including 433 regrafts. Actual perforation occurred in 876 (65.9%) patients. 420 (31.5%) grafts were for tectonic purposes alone and 217 (16.3%) were also grafted for visual rehabilitation. The main diagnostic categories were infection (39.4%), non-infectious ulcerative keratitis (32.2%) and other causes (ectasias, previous ocular surgery, injury, dystrophies and opacification). Graft survival of first eCG at 1, 2 and 5 years was 78%, 66% and 47%, respectively. Best-corrected visual acuity of surviving grafts at 1 year was: 6/12 or better in 29.9%, 6/18 to 6/60 in 38.4%, counting finger to LP in 30.6% and NPL in 1%, with worsening of vision in only 8.7% of the patients.

Conclusion This study which is the largest of its kind shows that despite the seriousness of the critical corneal pathology and the surgical challenges that it poses, the outcomes of eCG are favourable with most patients keeping their eyesight and avoiding immediate rejection. These clinical outcomes show the value of eye banking facilities that are developed to support corneal tissue supply for eCG.

Statistics from Altmetric.com

Footnotes

  • Contributors PH: contributions to the conception or design of the work; the acquisition, analysis or interpretation of data for the work; drafting the work or revising it critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. AKT: interpretation of data for the work; drafting the work or revising it critically for important intellectual content; final approval of the version to be published. DK: interpretation of data for the work; drafting the work or revising it critically for important intellectual content; final approval of the version to be published. MJ: contributions to the conception or design of the work; the acquisition, analysis or interpretation of data for the work; final approval of the version to be published. DA: interpretation of data for the work; drafting the work or revising it critically for important intellectual content; final approval of the version to be published.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval UK Blood and Transplant approved this study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.