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Major shifts in corneal transplantation procedures in north China: 5316 eyes over 12 years

Aims: To investigate the major shifts in the ratio of lamellar keratoplasty (LKP) to penetrating keratoplasty (PKP) and in the preoperative indications for each procedure. Methods: Medical records of patients who received LKP and/or PKP at Shandong Eye Institute between 1996 and 2007 were categorised and reviewed. The time period was divided into intervals of 1996–8, 1999–2001, 2002–4 and 2005–7. Results: A total of 4346 patients (5316 eyes) with integrated clinical records were included in the study. LKPs and PKPs were performed on 1558 eyes (29.3%) and 3758 eyes (70.7%), respectively. Within the first 3-year interval, the top three indications for LKP were chemical burns, keratoconus and corneal dermoid; the top reasons for PKP were viral keratitis, suppurative keratitis and corneal scarring. Within the last interval, suppurative keratitis, keratoconus and viral keratitis became most common indications for LKP and suppurative keratitis, viral keratitis and bullous keratopathy for PKP. The ratio of LKP to PKP operations tended to increase. Conclusion: Following proper indications, the use of LKP has increased in number in north China and has become particularly frequent in the management of corneal infections, keratoconus, corneal degeneration, and stromal dystrophy.