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Global issues
Trends in corneal graft surgery in the UK
  1. Tiarnan D L Keenan1,
  2. Fiona Carley1,
  3. David Yeates2,
  4. Mark N A Jones3,
  5. Sally Rushton3,
  6. Michael J Goldacre2 on behalf of the NHSBT Ocular Tissue Advisory Group and contributing ophthalmologists (OTAG Audit Study 8)
  1. 1University of Manchester and the Manchester Royal Eye Hospital, Manchester, UK
  2. 2Unit of Health-Care Epidemiology, Oxford University, Oxford, UK
  3. 3NHS Blood and Transplant, Watford, UK
  1. Correspondence to Mr Tiarnan D L Keenan, Manchester Royal Eye Hospital, Oxford Road, Manchester M13 9WH, UK; tiarnan.keenan{at}doctors.org.uk

Aims The aims of this study were to examine trends over time and regional variation in rates of corneal graft surgery in the UK.

Methods The hospital in-patient enquiry (HIPE) and hospital episode statistics (HES) were analysed for keratoplasty admissions in England from 1971 to 2006. NHS Blood and Transplant (NHSBT) data were analysed for keratoplasty operations in the UK from 1999 to 2009.

Results Annual rates of penetrating keratoplasty (PK) under HIPE and HES increased from 0.7 per 100 000 population (1971) to 3.9 (1992), then decreased to 3.1 (2006). Rates of lamellar keratoplasty (LK) increased from 0.1 (1971) to 0.9 (2006). Annual PK operations under NHSBT decreased from 1901 (1999/00) to 1473 (2008/9). Over the same period, deep anterior lamellar keratoplasty operations increased from 91 to 327 per year, while endothelial keratoplasty operations increased from 2 to 569 per year. Geographical analysis showed a wide variation across local authority areas in rates of keratoplasty around 1998–2004, especially for LK.

Conclusion The total number of corneal graft operations performed in the UK has increased slowly over the past decade. The proportion of lamellar versus penetrating keratoplasty has increased, with LK performed at the highest rates in specialist centres distributed across the UK.

  • Penetrating keratoplasty
  • lamellar keratoplasty
  • deep anterior lamellar keratoplasty
  • endothelial keratoplasty
  • cornea
  • epidemiology
  • treatment surgery
  • eye (tissue) banking

https://doi.org/10.1136/bjo.2010.182329

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    Aims The aims of this study were to examine trends over time and regional variation in rates of corneal graft surgery in the UK.

    Methods The hospital in-patient enquiry (HIPE) and hospital episode statistics (HES) were analysed for keratoplasty admissions in England from 1971 to 2006. NHS Blood and Transplant (NHSBT) data were analysed for keratoplasty operations in the UK from 1999 to 2009.

    Results Annual rates of penetrating keratoplasty (PK) under HIPE and HES increased from 0.7 per 100 000 population (1971) to 3.9 (1992), then decreased to 3.1 (2006). Rates of lamellar keratoplasty (LK) increased from 0.1 (1971) to 0.9 (2006). Annual PK operations under NHSBT decreased from 1901 (1999/00) to 1473 (2008/9). Over the same period, deep anterior lamellar keratoplasty operations increased from 91 to 327 per year, while endothelial keratoplasty operations increased from 2 to 569 per year. Geographical analysis showed a wide variation across local authority areas in rates of keratoplasty around 1998–2004, especially for LK.

    Conclusion The total number of corneal graft operations performed in the UK has increased slowly over the past decade. The proportion of lamellar versus penetrating keratoplasty has increased, with LK performed at the highest rates in specialist centres distributed across the UK.

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    Footnotes

    • Funding The Unit of Health-Care Epidemiology is funded to undertake research on the regional and national hospital databases by the English NHS National Coordinating Centre for Research Capacity Development. NHS Blood and Transplant is funded as a Special Health Authority whose responsibilities include acquiring information about donors and recipients of organs and tissues available for transplantation, and commissioning and conducting research and development.

    • Competing interests None.

    • Ethical approval Ethics approval was provided by NHS Central Office for Research Ethics Committees (reference 04/Q2006/176).

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