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. 2015 Sep-Oct;35(5):387-93.
doi: 10.5144/0256-4947.2015.387.

Indications and techniques employed for keratoplasty in the Eastern province of Saudi Arabia: 6 years of experience

Khalid M Al-Arfai, Sanaa A Yassin  1 , Ali S Al-Beshri, Mohanna Y Al-Jindan, Elham R Al-Tamimi
Affiliations

Indications and techniques employed for keratoplasty in the Eastern province of Saudi Arabia: 6 years of experience

Khalid M Al-Arfai et al. Ann Saudi Med. 2015 Sep-Oct.

Abstract

Background and objectives: Keratoplasty services in Saudi Arabia have progressed steadily in the past few decades. We sought to identify the leading indications and types of keratoplasty performed in the Eastern Province of Saudi Arabia over a six-year period and to compare these indications with published data.

Design and setting: This was a retrospective descriptive analysis of the records of patients who underwent keratoplasty at four ophthalmology centers in the Eastern Province between 2008 and 2013.

Patients and methods: All keratoplasty procedures were included in the analysis. The primary surgical indication and type of surgery were identified for each case.

Results: Keratoplasties included 570 penetrating keratoplasty, 217 deep lamellar keratoplasty, 80 triple procedures, 24 descemet stripping automated endothelial keratoplasty and 12 Boston keratoprosthesis implantations. The mean age of all patients was 28.8 years (range 14-72 years), and 58.9% of the patient were males. The lead.ing indication for keratoplasty was keratoconus 53.10%, bullous keratopathy 13.80%, corneal scarring 10.7%, regrafts 9.1%, and stromal dystrophies 4.9%.

Conclusions: In this study, the leading indications for keratoplasty were keratoconus, bullous keratopathy, corneal scarring, regrafts and stromal dystrophies. A significant increasing trend for descemet's stripping automated endothelial keratoplasty surgeries was observed in spite of the number of cases.

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Figures

Figure 1
Figure 1
Most common procedures performed in Eastern Province, Saudi Arabia (2008–2013). PKP: Penetrating keratophy; DLKP: Deep lamellar keratophy; t-PKP: Penetrating keratoplasty with cataract extraction and intraocular lens implantation; DSAEK: Descemet’s stripping automated endothelial keratoplasty; KPro: Boston keratoprothesis and t-DSAEK: DSAEK with cataract extraction and intraocular lens implantation.
Figure 2
Figure 2
Trends in different keratoplasty techniques in the last six years. PKP: Penetrating keratophy; DLKP: Deep lamellar keratophy; DSAEK: Descemet’s stripping automated endothelial keratoplasty; KPro: Boston keratoprothesis.
Figure 3
Figure 3
Major indications for keratoplasty. Other non-Fuchs’ corneal dystrophies: congenital hereditary endothelial dystrophy, posterior polymorphous dystrophy, basement membrane dystrophy; Other corneal diseases include: Pellucid marginal degeneartion, climatic droplet keratopathy, failed keratoprosthesis, corneal blood staining and sclerocornea.
Figure 4
Figure 4
Age distribution of patients with keratoconus who underwent keratoplasty showing peaked frequency in the early 20s.
Figure 5
Figure 5
Percentage of keratoconus cases finally treated with keratoplasty in different countries compared with our study.
See this image and copyright information in PMC

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