TRANSPLANT DATA, 2004-2009 .1 Recipient Data
10
Table 2.3.1.3: Pre-operative Vision, 2004-2009
Year 2004
N=138 2005
N=192 2006
N=177 2007
N=196 2008
N=231 2009
N=209 TOTAL
N=1143 Unaided
VA No. No. No. No. No. No. No.
66 3 2 0 0 1 1 1 1 1 1 1 1 7 1
69 1 1 1 1 1 1 2 1 6 2 2 1 13 1
612 0 0 2 1 3 1 0 0 2 1 2 1 9 1
618 0 0 1 1 0 0 2 1 1 1 3 1 7 1
624 3 2 5 2 4 2 2 1 3 1 4 2 21 2
636 4 3 6 3 5 3 3 1 6 2 6 3 30 3
660 7 5 16 8 17 10
11 5 14 6 17 8 82 7 560
1 1 0 0 0 0 0 0 0 0 0 0 1 0 460
3 2 1 1 2 1 2 1 0 0 0 0 8 1 360
2 1 2 1 1 1 4 2 5 2 5 2 19 2 260
1 1 2 1 4 2 1 1 2 1 4 2 14 1 160
4 3 9 4 7 4 2 1 1 1 6 3 29 2 CF
47 34 47 24 45 25
43 22 40 17 70 33 292 25 HM
47 34 46 24 37 21
48 24 48 21 55 26 281 24 PL
13 10 15 8 12 7 17 9 20 9 15 7 92 8 NPL
2 1 1 1 0 0 1 1 0 0 1 1 5 1 Others
0 0 0 0 0 0 0 0 0 0 1 1 1 0 No
data 0 0 38 20
38 21 57 29 82 35 17 8 232 20
11
CORNEAL TRANSPLANTATION
2.3.2: Donor details Eye Banks in the United States of America USA were the most frequent source of the
corneal tissues Table 2.3.2.1. The majority of donors were elderly patients with a median age of 59 years Table 2.3.2.2. Optisol GS was the commonest corneal tissue
storage medium used at 76 Table 2.3.2.3. The major cause of death of the donors were related to the cardiaccirculatory system 30 followed by malignancy 15
Table 2.3.2.4. Table 2.3.2.1: Source of Donor Cornea Tissue, 2004-2009
Year 2004 N=138
2005 N=192
2006 N=177
2007 N=196
2008 N=231
2009 N=209
TOTAL N=1143
Source of donor No. No. No. No.
No. No. No.
Local 20 14 19 10
36 20 31 16
41 18 41 20 188 16
USA 95 69 133 69
98 56 114 58 150 65 130 62 720 63 Sri Lanka
22 16 38 20 41 23
51 26 37 16
38 18 227 19 Others
0 0 0 0 2 1 0 0 2 1 0 0 4 1 No data
1 1 2 1 0 0 0 0 1 0 0 0 4 1 If Local, ethnic group:
x Malay
0 0 4 21 1 3 5 16
0 0 0 0 10 5 x
Chinese 14 70 8 42
12 33 16 52
22 54 29 71 101 54
x Indian
5 25 7 37 23 64
4 13 9 22
12 29 60 32 x
Others 0 0 0 0 0 0 4 13
10 24 0 0 14 7
x Unknown
1 5 0 0 0 0 2 6 0 0 0 0 3 2 In the year 2004 there were a total of 184 corneal transplants performed but complete data set was only
received for 138 patients.
Figure 2.3.2.1: Source of Donor Corneal Tissue, 2004-2009
Perce n
t
Year 10
20 30
40 50
60 70
Local USA
Sri Lanka Others
2004 2005
2006 2007
2008 2009
12
Table 2.3.2.2: Donor Age Distribution, 2004-2009
Year 2004
N=138 2005
N=192 2006
N=177 2007
N=196 2008
N=231 2009
N=209 TOTAL
N=1143 Age group
years
No. No. No. No. No. No. No.
0-9 2 2 3 2 2 1 2 1 7 3 2 1 18 2
10-19 6 4 4 2 9 5 5 3 7 3 9 4 40 3
20-39 11 8 7 4 11 6 13 7 19 8 17 8 78 7
40-59 51 37 89 46 81 46 83 42 80 35 85 41 469 41
60 68 49 89 46 74 42 93 47 118 51 96 46 538 47
Mean 57 58 56 57 56 56 57 SD
15 14 16 14 17 16 15 Median 59 58 56 59 60 58 59
Minimum 8 3 6 4 1 1 1
Maximum 78 79 78 78 76 77 79
Table 2.3.2.3: Preservation Media, 2004-2009
Year 2004 N=138
2005 N=192
2006 N=177
2007 N=196
2008 N=231
2009 N=209
TOTAL N=1143
Preservation media No. No. No. No.
No. No. No.
Optisol GS
90 65 145 75 128 72 134 68 189
82 183 88 869 76 MK
Medium 22 16 37 19
40 23 51 26 35 15 15 7 200 17
Moist Chamber
4 3 3 2 7 4 8 4 4 2 8 4 34 3 Others
0 0 1 1 0 0 3 2 1 0 0 0 5 1 No
data 22
16 6 3 2 1 0 0 2 1 3 1 35 3
Others specify Eusol-C
Figure 2.3.2.3: Preservation Media, 2004-2009
Perce nt
Year 10
20 30
40 50
60 70
80 Optisol
MK Medium Moist Chamber
2004 2005
2006 2007
2008 2009
13
CORNEAL TRANSPLANTATION
Table 2.3.2.4: Cause of Death in Corneal Donors, 2004-2009
Year 2004 N=138
2005 N=192
2006 N=177
2007 N=196
2008 N=231
2009 N=209
TOTAL N=1143
Cause of death
No. No. No. No. No.
No. No.
Cardiac Circulatory System
47 34 49 26 59 33
75 38 61 26 58 28 349 30 Cerebrovascular System
17 12 25 13 11 6 23 12 35 15 18 9 129 11
Malignancy 19 14 31 16
25 14 26 13 41 18 27 13 169 15
Trauma Accident 20 15 13 7 19 11
24 12 21 9 28 13 125 11 Respiratory System
15 11 8 4 8 5 13 7 10 4 25 12 79 7
Others 17 12 21 11
27 15 32 16 59 26 49 23 205 18
No data 3 2 45 23
28 16 3 2 4 2 4 2
87 8
2.3.3: Transplant Practices Penetrating Keratoplasty PK was the commonest type of surgery performed 86
Table 2.3.3.1. Corneal transplantation was performed in combination with other surgical procedures in 18 of cases. Cataract extraction, with or without intraocular
lens implantation IOL, was the commonest combined procedure Table 2.3.3.2.The recipient graft size ranged from 2mm to 10mm, with the median recipient cornea graft
size being 7.5mm.Table 2.3.3.3. The majority of cases had the donor tissue over-sized by 0.5mm Table 2.3.3.4. The commonest suturing technique was interrupted sutures
Table 2.3.3.5. Table 2.3.3.1: Types of Surgeries, 2004-2009
Year 2004 N=138
2005 N=192
2006 N=177
2007 N=196
2008 N=231
2009 N=209
TOTAL N=1143
Type of surgery No. No.
No. No.
No. No. No.
Penetrating Keratoplasty 120 87 173 90 153 86 175 89 189 82 173 82 983 86
Lamellar Keratoplasty 10 7 13 7 16 9 7 4 21 9 15 7 82 7
Patch Graft for Corneal 2 2 3 1 5 3 10 5 12 5 9 4 41 4
Patch Graft for Scleral 0 0 1 1 0 0 0 0 2 1 1 1 4 0
Cornea Scleral Keratoplasty 6 4 2 1 3 2 4 2 4 2 10 5 29 3
Endothelial keratoplasty 0 0 0 0 0 0 0 0 3 1 0 0 3 0
Others 0 0 0 0 0 0 0 0 0 0 1 1 1 0
In the year 2004 there were a total of 184 corneal transplants performed but complete data set was only received for 138 patients.
Table 2.3.3.2: Types of Combined Surgeries, 2004-2009
Year 2004 N=138
2005 N=192
2006 N=177
2007 N=196
2008 N=231
2009 N=209
TOTAL N=1143
Combined surgeries
No. No. No.
No. No.
No. No.
No. of patients with corneal transplant surgery
combined with another surgical procedure
30 22 27 14 41 23 35 18 46 20 32 15 211 18 a Glaucoma surgery
2 7 3 11 1 2 0 0 3 7 2 6 11 5 b Cataract Extraction
15 50 13 48 21 51 13 37 17 37 15 47 94 45 c IOL
13 43 10 37 24 59 19 54 23 50 10 31 99 47 d Cataract extraction and
IOL 9 30 8 30 15 37 10 29 16 35 9 28 67 32
e Retinal Surgery + Internal Tamponade
1 3 1 4 2 5 4 11 10
22 0 0 18 9 f
Anterior vitrectomy
9 30 3 11 4 10 10 29 6 13 9 28 41 19 g
Others 5 17 8 30 8 20 16 46 14 30 11 34 62 29
Patients may have more than one combined surgery.
14
Table 2.3.3.3: Recipient Cornea Trephine Size, 2004-2009
Year 2004
N=138 2005
N=192 2006
N=177 2007
N=196 2008
N=231 2009
N=209 TOTAL
N=1143 Graft size,
mm
No. No. No. No. No. No. No.
2 1 1 1 1 2 1 1 1 0 0 1 1 6 1
3 0 0 1 1 2 1 1 1 1 1 2 1 7 1
4 1 1 2 1 1 1 5 2 2 1 1 1 12 1
5 0 0 0 0 0 0 1 1 1 0 1 1 3 1
5.5 1 1 0 0 0 0 0 0 0 0 0 0 1 0
6 3 2 0 0 5 3 4 2 4 1 7 3 23 2
6.25 0 0 1 1 0 0 0 0 0 0 0 0 1 0
6.5 2 1 5 2 4 2 8 4 7 3 9 4 35 3
6.7 0 0 0 0 0 0 0 0 1 1 0 0 1 0
6.75 1 1 3 1 2 1 1 1 1 1 2 1 10 1
7 25 18 36 19 25 14 29 15 38 16 35 16 188 16
7.2 1 1 0 0 0 0 0 0 1 1 0 0 2 0
7.25 9 7 10 5 14 8 5 2 5 2 10 5 53 5
7.5 36 26 18 9 26 15 37 19 50 21 33 16 200 17
7.75 8 5 11 6 6 3 12 6 14 6 47 22 98 8
7.8 2 1 0 0 0 0 0 0 0 0 0 0 2 0
8 18 13 7 4 13 7 19 10 26 11 25 12 108 9
8.15 0 0 0 0 0 0 0 0 1 1 0 0 1 0
8.25 4 3 4 2 5 3 4 2 4 2 4 2 25 2
8.5 6 4 6 3 2 1 11 5 10 4 5 2 40 3
8.75 0 0 1 1 0 0 0 0 0 0 0 0 1 0
9 9 7 3 1 1 1 4 2 3 1 6 3 26 2
9.5 0 0 2 1 0 0 0 0 1 0 2 1 5 1
10 1 1 0 0 0 0 0 0 2 1 3 1 6 1
10.5 0 0 0 0 0 0 0 0 0 0 1 1 1 0
11 0 0 0 0 0 0 0 0 1 1 2 1 3 1
12 0 0 0 0 0 0 0 0 1 1 0 0 1 0
No data
10 7 81 42 69 39 54 27 57 24 13 6 284 25 Mean
7.5 7.3 7.2 7.3
7.5 7.5 7.4
SD 0.9 1
1.1 1.1
0.9 1 1
Median 7.5 7.3 7.3
7.5 7.5
7.5 7.5 Minimum
2 2 2 2
3 2 2
Maximum 10 9.5 9
9 12
11 12
15
CORNEAL TRANSPLANTATION
Table 2.3.3.4: Difference in Trephined Sizes of Recipient and Donor Corneas, 2004- 2009
Year 2004
N=138 2005
N=192 2006
N=177 2007
N=196 2008
N=231 2009
N=209 TOTAL
N=1143 Difference in
Graft size, mm
No. No. No.
No. No.
No. No.
Same Size
9 6 8 4 8 4 12 6 19 8 51 24 107 9
0.2 2 1 0 0 0 0 0 0 2 1 0 0 4 0
0.25 22 16 19 10 30 17 27 14 27 12 36 17 161 14
0.3 5 4 0 0 0 0 0 0 0 0 1 1 6 1
0.4 1 1 0 0 0 0 0 0 0 0 0 0 1 0
0.5 86 62 84 44 67 38 95 48 117
51 99 47 548 48 0.55
0 0 0 0 0 0 0 0 1 0 0 0 1 0 0.6
0 0 0 0 0 0 0 0 1 0 0 0 1 0 0.75
0 0 0 0 1 1 1 1 2 1 1 1 5 1 0.8
1 1 0 0 0 0 0 0 0 0 0 0 1 0 1
1 1 0 0 1 1 4 2 2 1 5 2 13 1 1.5
0 0 0 0 0 0 0 0 1 0 1 1 2 0 2
1 1 0 0 0 0 0 0 0 0 0 0 1 0 Not
Available 10 7 81 42 70 39 57 29 59 26 15 7 292 26
Table 2.3.3.5: Suture Technique, 2004-2009
Year 2004
N=138 2005
N=192 2006
N=177 2007
N=196 2008
N=231 2009
N=209 TOTAL
N=1143 Suture
Technique No. No. No. No.
No. No. No.
Interrupted only 132 96 139 73 124
70 138 70 171
74 175 84 879 77 Continuous only
0 0 0 0 5 3 1 1 6 3 7 3 19 2 Combined
6 4 18 9 18 10 12 6 10 4 25 12 89 8 No data
0 0 35 18 30 17 45 23 44 19 2 1 156 13
16
2.4 CORNEAL TRANSPLANT OUTCOME 2004-2009 Table 2.4.1: Stock and Flow - Graft Status Whole Database
Optical Non optical
Total No.
No. No.
Number registered
810 68 379 32 1189 100
Number followed Total
327 156 483
1 year
201 62 121 78 322 67 2 year
70 21 24 15 94 19
3 year 42 13 7 5 49 10
4 year 10 3 4 2 14 3
5year 4 1 0 0 4
1
Graft status Total
327 156 483
-Surviving graft 260 80 84 54 344 71
-Failed graft 67 20 72 46 139 29
Recipient status Total
810 379 1189
-Recipient with complete follow up 99 12 78 20
177 15 -Recipient deaths
3 0 1 0 4 -Recipient loss - followed
224 28 77 21 301 25 -Recipient loss - not followed
374 46 124 33 499
42 -Graft not yet followed
Transplant duration less than 1 year 110 14 99 26 209 18
17
CORNEAL TRANSPLANTATION
2.4.2 Outcome – Graft Survival 2004-2009 Graft survival for both optical and non-optical indications at 12 months was 77.2 but
this declined to 64.5 at 36 months Table 2.4.2.1. The cases were grouped into two groups based on the indication for surgery – i Optical and ii Non-Optical. Graft
survival was 86.8 at 12 months in the optical group and 57.1 in the non-optical group. This declined to 72.3 at 36 months in the optical group and 48.5 in the non-
optical group Table 2.4.2.2. Primary graft failure was the commonest cause of graft failure.Table 2.4.2.5.
Table 2.4.2.1: Graft Survival, 2004-2009
Interval months No.
success SE
0 483 100
- 12 375
77.2 2
24 161 70.4
2 36 67
64.5 3
48 18 53.
4 6
60 4 47.5
8
Figure 2.4.2.1: Graft Survival, 2004-2009
0.00 0.20
0.40 0.60
0.80 1.00
Cu mu
lativ e su
rv iv
al
12 24
36 48
60 Duration in months