Purpose: To analyze recent trends in the indications for penetrating keratoplasty.
Methods: After keratoplasty, 2,557 corneal buttons were sent to and analyzed in the ophthalmopathology laboratory of the University of Erlangen-Nürnberg, Erlangen, Germany, between 1992 and 1996. Of these, 1,250 random corneal buttons were evaluated in this study.
Results: Histopathologic diagnoses were (a) keratoconus (20.9%), (b) corneal scarring after keratitis/trauma (20.4%), (c) pseudophakic/aphakic bullous keratopathy (17%), (d) regraft (15.5%), (e) Fuchs' corneal endothelial dystrophy (14.9%), (f) necrotizing/ulcerative keratitis (5.3%), and (g) corneal dystrophies (1.7%).
Conclusion: Compared with a previous report from our laboratory (1964-1986), the relative frequencies of pseudophakic/aphakic bullous keratopathy, regraft, and Fuchs' dystrophy increased, whereas corneal scarring decreased. Keratoconus is now the most frequent indication for penetrating keratoplasty.