. 2020 Oct 15;15(10):e0239939.

doi: 10.1371/journal.pone.0239939. eCollection 2020.

Survey report on keratoplasty in China: A 5-year review from 2014 to 2018

Hua Gao^{1

2}, Ting Huang^{2

3}, Zhiqiang Pan^{2

4}, Jie Wu^{2

5}, Jianjiang Xu^{2

6}, Jing Hong^{2

7}, Wei Chen^{2

8}, Huping Wu⁹, Qian Kang¹⁰, Lei Zhu^{2

11}, Lingling Fu¹², Liqiang Wang^{2

13}, Guigang Li^{2

14}, Zhihong Deng¹⁵, Hong Zhang^{2

16}, Hui Xu¹⁷, Qingliang Zhao¹⁸, Hongshan Liu¹⁹, Linnong Wang^{2

20}, Baihua Chen^{2

21}, Xiuming Jin^{2

22}, Minghai Huang²³, Jizhong Yang²⁴, Minghong Gao^{2

25}, Wentian Zhou²⁶, Hanping Xie^{2

27}, Yao Fu^{2

28}, Feng Wen²⁹, Changbo Fu³⁰, Shaozhen Zhao^{2

31}, Yanning Yang^{2

32}, Yanjiang Fu³³, Tao Yao³⁴, Chaoqing Wang³⁵, Xiaonan Sun³⁶, Xiaowei Gao^{2

37}, Maimaitiming Reziwan³⁸, Yingping Deng^{2

39}, Jian Li⁴⁰, Limei Liu⁴¹, Bo Zeng⁴², Lianyun Bao⁴³, Hua Wang^{2

44}, Lijun Zhang^{2

45}, Zhiyuan Li⁴⁶, Zhijian Yin⁴⁷, Yuechun Wen⁴⁸, Xiao Zheng⁴⁹, Liqun Du⁵⁰, Zhenping Huang⁵¹, Xunlun Sheng⁵², Hui Zhang^{2

53}, Lizhong Chen⁵⁴, Xiaoming Yan^{2

55}, Xiaowei Liu⁵⁶, Wenhui Liu⁵⁷, Yuan Liu⁵⁸, Liang Liang⁵⁹, Pengcheng Wu⁶⁰, Lijun Qu⁶¹, Jinkui Cheng⁶², Hua Zhang⁶³, Qige Qi⁶⁴, Yangkyi Tseten⁶⁵, Jianping Ji³, Jin Yuan^{2

3}, Ying Jie⁴, Jun Xiang⁶, Yifei Huang^{2

13}, Yuli Yang^{2

27}, Ying Li^{2

56}, Yiyi Hou¹, Tong Liu¹, Lixin Xie^{2

66}, Weiyun Shi^{1

2}

Affiliations

¹ Department of Ophthalmology, Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China.
² Corneal Disease Group of Ophthalmological Society of Chinese Medical Association (China Cornea Society), Jinan, China.
³ Department of Ophthalmology, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou, China.
⁴ Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
⁵ Department of Ophthalmology, No.1 Hospital of Xi'an City, Xian, China.
⁶ Department of Ophthalmology, Eye and Ear, Nose, Throat Hospital, Fudan University, Shanghai, China.
⁷ Department of Ophthalmology, Peking University Third Hospital, Beijing, China.
⁸ Department of Ophthalmology, Eye Hospital of Wenzhou Medical University, Wenzhou, China.
⁹ Department of Ophthalmology, Affiliated Xiamen Eye Center of Xiamen University, Xiamen, China.
¹⁰ Department of Ophthalmology, Chengdu AiDi Eye Hospital, Chengdu, China.
¹¹ Department of Ophthalmology, Henan Eye Institute, Henan Eye Hospital, Zhengzhou, China.
¹² Department of Ophthalmology, Hefei Puri Ophthalmological Hospital, Hefei, China.
¹³ Department of Ophthalmology, Chinese PLA General Hospital, Medical School of Chinese PLA, Beijing, China.
¹⁴ Department of Ophthalmology, TongJi Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
¹⁵ Department of Ophthalmology, The Third Xiangya Hospital of Central South University, Changsha, China.
¹⁶ Department of Ophthalmology, The First Affiliated Hospital of Harbin Medical University, Harbin, China.
¹⁷ Department of Ophthalmology, The First Hospital of Jilin University, Changchun, China.
¹⁸ Department of Ophthalmology, Suzhou Lixiang Eye Hospital, Suzhou, China.
¹⁹ Department of Ophthalmology, Hainan Eye Institute, Hainan Eye Hospital, Haikou, China.
²⁰ Department of Ophthalmology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
²¹ Department of Ophthalmology, Second Xiangya Hospital, Central South University, Changsha, China.
²² Department of Ophthalmology, Affiliated Second Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
²³ Department of Ophthalmology, Nanning Aier Eye Hospital, Nanning, China.
²⁴ Department of Ophthalmology, Shanxi Eye Hospital, Taiyuan, China.
²⁵ Department of Ophthalmology, General Hospital of Northern Theater Command Hospital, Shenyang, China.
²⁶ Department of Ophthalmology, Affiliated Eye Hospital of Nanchang University, Nanchang, China.
²⁷ Department of Ophthalmology, The First Hospital Affiliated to Army Medical University, Chongqing, China.
²⁸ Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
²⁹ Department of Ophthalmology, Ningbo Eye Hospital, Ningbo, China.
³⁰ Department of Ophthalmology, Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University, Xuzhou, China.
³¹ Department of Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China.
³² Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, China.
³³ Department of Ophthalmology, Daqing Ophthalmologic Hospital, Daqing, China.
³⁴ Department of Ophthalmology, Shenyang He Eye Hospital, Shenyang, China.
³⁵ Department of Ophthalmology, Jinan Mingshui Eye Hospital, Jinan, China.
³⁶ Department of Ophthalmology, The 4th People's Hospital of Shenyang, Shenyang, China.
³⁷ Department of Ophthalmology, 474 Hospital of PLA, Urumchi, China.
³⁸ Department of Ophthalmology, Urumqi City Ophthalmology and Otolaryngology Hospital, Urumchi, China.
³⁹ Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, China.
⁴⁰ Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.
⁴¹ Department of Ophthalmology, Weifang Eye Hospital, Weifang, China.
⁴² Department of Ophthalmology, General Hospital of the Central Theater of the Chinese People's Liberation Army, Wuhan, China.
⁴³ Department of Ophthalmology, Nanjing Ningyi Eye Center, Nanjing, China.
⁴⁴ Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha, China.
⁴⁵ Department of Ophthalmology, The People's Third Hospital of Dalian, Dalian Medical University, Dalian, China.
⁴⁶ Department of Ophthalmology, The People's No.1 Hospital of Chenzhou, Chenzhou, China.
⁴⁷ Department of Ophthalmology, The First Affiliated Hospital of Dali University, Dali, China.
⁴⁸ Department of Ophthalmology, The First Affiliated Hospital of University of Science and Technology of China, Anhui Provincial Hospital, Hefei, China.
⁴⁹ Department of Ophthalmology, The Army Characteristic Medical Center, Chongqing, China.
⁵⁰ Department of Ophthalmology, Qilu Hospital of Shandong University, Jinan, China.
⁵¹ Department of Ophthalmology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
⁵² Department of Ophthalmology, Ningxia Eye Hospital, The People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, China.
⁵³ Department of Ophthalmology, First Affiliated Hospital of Kunming Medical University, Kunming, China.
⁵⁴ Department of Ophthalmology, Lunan Eye Hospital, Linyi, China.
⁵⁵ Department of Ophthalmology, Peking University First Hospital, Beijing, China.
⁵⁶ Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
⁵⁷ Department of Ophthalmology, Wuxi Second People's Hospital, Wuxi, China.
⁵⁸ Department of Ophthalmology, Guizhou Jinglang Eye Hospital, Guiyang, China.
⁵⁹ Department of Ophthalmology, Yichang Central People's Hospital, Yichang, China.
⁶⁰ Department of Ophthalmology, Lanzhou University Second Hospital, Lanzhou, China.
⁶¹ Department of Ophthalmology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
⁶² Department of Ophthalmology, Jingzhou First People's Hospital, Jingzhou, China.
⁶³ Department of Ophthalmology, Shijiazhuang No.1 Hospital, Shijiazhuang, China.
⁶⁴ Department of Ophthalmology, Hulunbuir People's Hospital, Hulunbuir, China.
⁶⁵ Department of Ophthalmology, Tibetan Traditional Tibet Medical Hospital of Tibet Autonomous Region, Lhasa, China.
⁶⁶ Department of Ophthalmology, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China.

PMID: 33057425
PMCID: PMC7561196
DOI: 10.1371/journal.pone.0239939

Survey report on keratoplasty in China: A 5-year review from 2014 to 2018

Hua Gao et al. PLoS One. 2020.

. 2020 Oct 15;15(10):e0239939.

doi: 10.1371/journal.pone.0239939. eCollection 2020.

Authors

Affiliations

¹ Department of Ophthalmology, Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China.
² Corneal Disease Group of Ophthalmological Society of Chinese Medical Association (China Cornea Society), Jinan, China.
³ Department of Ophthalmology, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou, China.
⁴ Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
⁵ Department of Ophthalmology, No.1 Hospital of Xi'an City, Xian, China.
⁶ Department of Ophthalmology, Eye and Ear, Nose, Throat Hospital, Fudan University, Shanghai, China.
⁷ Department of Ophthalmology, Peking University Third Hospital, Beijing, China.
⁸ Department of Ophthalmology, Eye Hospital of Wenzhou Medical University, Wenzhou, China.
⁹ Department of Ophthalmology, Affiliated Xiamen Eye Center of Xiamen University, Xiamen, China.
¹⁰ Department of Ophthalmology, Chengdu AiDi Eye Hospital, Chengdu, China.
¹¹ Department of Ophthalmology, Henan Eye Institute, Henan Eye Hospital, Zhengzhou, China.
¹² Department of Ophthalmology, Hefei Puri Ophthalmological Hospital, Hefei, China.
¹³ Department of Ophthalmology, Chinese PLA General Hospital, Medical School of Chinese PLA, Beijing, China.
¹⁴ Department of Ophthalmology, TongJi Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
¹⁵ Department of Ophthalmology, The Third Xiangya Hospital of Central South University, Changsha, China.
¹⁶ Department of Ophthalmology, The First Affiliated Hospital of Harbin Medical University, Harbin, China.
¹⁷ Department of Ophthalmology, The First Hospital of Jilin University, Changchun, China.
¹⁸ Department of Ophthalmology, Suzhou Lixiang Eye Hospital, Suzhou, China.
¹⁹ Department of Ophthalmology, Hainan Eye Institute, Hainan Eye Hospital, Haikou, China.
²⁰ Department of Ophthalmology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
²¹ Department of Ophthalmology, Second Xiangya Hospital, Central South University, Changsha, China.
²² Department of Ophthalmology, Affiliated Second Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
²³ Department of Ophthalmology, Nanning Aier Eye Hospital, Nanning, China.
²⁴ Department of Ophthalmology, Shanxi Eye Hospital, Taiyuan, China.
²⁵ Department of Ophthalmology, General Hospital of Northern Theater Command Hospital, Shenyang, China.
²⁶ Department of Ophthalmology, Affiliated Eye Hospital of Nanchang University, Nanchang, China.
²⁷ Department of Ophthalmology, The First Hospital Affiliated to Army Medical University, Chongqing, China.
²⁸ Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
²⁹ Department of Ophthalmology, Ningbo Eye Hospital, Ningbo, China.
³⁰ Department of Ophthalmology, Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University, Xuzhou, China.
³¹ Department of Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China.
³² Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, China.
³³ Department of Ophthalmology, Daqing Ophthalmologic Hospital, Daqing, China.
³⁴ Department of Ophthalmology, Shenyang He Eye Hospital, Shenyang, China.
³⁵ Department of Ophthalmology, Jinan Mingshui Eye Hospital, Jinan, China.
³⁶ Department of Ophthalmology, The 4th People's Hospital of Shenyang, Shenyang, China.
³⁷ Department of Ophthalmology, 474 Hospital of PLA, Urumchi, China.
³⁸ Department of Ophthalmology, Urumqi City Ophthalmology and Otolaryngology Hospital, Urumchi, China.
³⁹ Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, China.
⁴⁰ Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.
⁴¹ Department of Ophthalmology, Weifang Eye Hospital, Weifang, China.
⁴² Department of Ophthalmology, General Hospital of the Central Theater of the Chinese People's Liberation Army, Wuhan, China.
⁴³ Department of Ophthalmology, Nanjing Ningyi Eye Center, Nanjing, China.
⁴⁴ Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha, China.
⁴⁵ Department of Ophthalmology, The People's Third Hospital of Dalian, Dalian Medical University, Dalian, China.
⁴⁶ Department of Ophthalmology, The People's No.1 Hospital of Chenzhou, Chenzhou, China.
⁴⁷ Department of Ophthalmology, The First Affiliated Hospital of Dali University, Dali, China.
⁴⁸ Department of Ophthalmology, The First Affiliated Hospital of University of Science and Technology of China, Anhui Provincial Hospital, Hefei, China.
⁴⁹ Department of Ophthalmology, The Army Characteristic Medical Center, Chongqing, China.
⁵⁰ Department of Ophthalmology, Qilu Hospital of Shandong University, Jinan, China.
⁵¹ Department of Ophthalmology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
⁵² Department of Ophthalmology, Ningxia Eye Hospital, The People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, China.
⁵³ Department of Ophthalmology, First Affiliated Hospital of Kunming Medical University, Kunming, China.
⁵⁴ Department of Ophthalmology, Lunan Eye Hospital, Linyi, China.
⁵⁵ Department of Ophthalmology, Peking University First Hospital, Beijing, China.
⁵⁶ Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
⁵⁷ Department of Ophthalmology, Wuxi Second People's Hospital, Wuxi, China.
⁵⁸ Department of Ophthalmology, Guizhou Jinglang Eye Hospital, Guiyang, China.
⁵⁹ Department of Ophthalmology, Yichang Central People's Hospital, Yichang, China.
⁶⁰ Department of Ophthalmology, Lanzhou University Second Hospital, Lanzhou, China.
⁶¹ Department of Ophthalmology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
⁶² Department of Ophthalmology, Jingzhou First People's Hospital, Jingzhou, China.
⁶³ Department of Ophthalmology, Shijiazhuang No.1 Hospital, Shijiazhuang, China.
⁶⁴ Department of Ophthalmology, Hulunbuir People's Hospital, Hulunbuir, China.
⁶⁵ Department of Ophthalmology, Tibetan Traditional Tibet Medical Hospital of Tibet Autonomous Region, Lhasa, China.
⁶⁶ Department of Ophthalmology, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China.

PMID: 33057425
PMCID: PMC7561196
DOI: 10.1371/journal.pone.0239939

Abstract

To provide the general information on corneal transplantation (CT) in China, China Cornea Society designed a questionnaire on CT from 2014 to 2018 and entrusted it to 31 committee members for implementation of the survey nationwide. This article presents the results of the survey and compares the indicators used in the survey and those in the annual statistical report released by the Eye Bank Association of America (EBAA). The number of corneal transplantations completed by the 64 hospitals from 2014 to 2018 was respectively 5377, 6394, 7595, 8270 and 8980, totally 36,616 (22,959 male and 13,657 female). The five largest hospitals by the number of corneal transplantations completed 15,994 surgeries in total, accounting for 43.68% of all the surgeries performed in the 64 hospitals. The most common indication for corneal transplantations was corneal leukoma (7683, 20.98%), followed by bacterial keratitis (4209, 11.49%), corneal dystrophies (4189, 11.44%), keratoconus (3578, 9.77%) and corneal perforation (2839, 7.75%). The main surgical techniques were penetrating keratoplasty (PK) (19,896, 54.34%), anterior lamellar keratoplasty (ALK) (13,869, 37.88%). The proportion of PK decreased from 57.97% in 2014 to 52.88% in 2018 while the proportion of ALK increased from 36.04% in 2014 to 37.92% in 2018. The geographical distribution of keratoplasties performed in China is unbalanced. PK and ALK were the main techniques of CT and corneal leukoma, bacterial keratitis and corneal dystrophies were the main indications for CT in China.

PubMed Disclaimer

Conflict of interest statement

Competing interests: The authors have declared that no competing interests exist.

Figures

**Fig 1. Number of corneal transplants performed in each involved hospital.**
1: Shandong Eye Institute 2: Zhongshan Ophthalmic Centre, Sun Yat-sen University 3: Beijing Tongren Hospital, Capital Medical University 4: No.1 Hospital of Xi’an City 5: Eye and Ear, Nose, Throat Hospital, Fudan University 6: Peking University Third Hospital 7: Eye Hospital of Wenzhou Medical University 8: Affiliated Xiamen Eye Center of Xiamen University 9: Chengdu AiDi Eye Hospital 10: Henan Eye Institute, Henan Eye Hospital 11: Hefei Puri Ophthalmological Hospital 12: Chinese PLA General Hospital, Medical School of Chinese PLA 13: TongJi Hospital, Tongji Medical College, Huazhong University of Science and Technology 14: The Third Xiangya Hospital of Center South University 15: The First Affiliated Hospital of Harbin Medical University 16: The First Hospital of Jilin University 17: Suzhou Lixiang Eye Hospital 18: Henan Eye Institute, Henan Eye Hospital 19: Nanjing First Hospital, Nanjing Medical University 20: Department of Ophthalmology, Second Xiangya Hospital, Central South University 21: Affiliated Second Hospital, School of Medicine, Zhejiang University 22: Nanjing Aier Eye Hospital 23: Shanxi Eye Hospital 24: General Hospital of Northern Theater Command Hospital 25: Affiliated Eye Hospital of Nanchang University 26: The First Hospital Affiliated to Army Medical University 27: Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine 28: Ningbo Eye Hospital 29: Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University 30: Tianjin Medical University Eye Hospital 31: Renmin Hospital of Wuhan University 32: Daqing Ophthalmologic Hospital 33: Shenyang He Eye Hospital 34: Jinan Mingshui Eye Hospital 35: The 4th People's Hospital of Shenyang 36: 474 Hospital of PLA 37: Urumqi City Ophthalmology and Otolaryngology Hospital 38: West China Hospital of Sichuan University 39: The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital 40: Weifang Eye Hospital 41: General Hospital of the Central Theater of the Chinese People’s Liberation Army, Wuhan, Hubei Province 42: Nanjing Ningyi Eye Center 43: Department of Ophthalmology, Xiangya Hospital, Central South University 44: The People’s Third Hospital of Dalian, Dalian Medical University, The third People's Hospital of Dalian 45: The People's No.1 Hospital of Chenzhou 46: The First Affiliated Hospital of Dali University 47: The First Affiliated Hospital of University of Science and Technology of China, Anhui Provincial Hospital 48: The Army Characteristic Medical Center 49: Qilu Hospital of Shandong University 50: Jinling Hospital, Nanjing University School of Medicine 51: Ningxia Eye Hospital, The People’s Hospital of Ningxia Hui Autonomous Region 52: First Affiliated Hospital of Kunming Medical University 53: Lunan Eye Hospital 54: Peking University First Hospital 55: Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College 56: Wuxi Second People's Hospital 57: Guizhou Jinglang Eye Hospital 58: Yichang Central People's Hospital 59: Lanzhou University Second Hospital 60: The Second Affiliated Hospital of Harbin Medical University 61: Jingzhou First People's Hospital 62: Shijiazhuang No.1 Hospital 63: Hulunbuir People's Hospital 64: Tibetan Traditional Tibet Medical Hospital of Tibet Autonomous Region.

**Fig 2. Indications for corneal transplantation.**

**Fig 3. Tendency of preferred surgical techniques.**
ALK = anterior lamellar keratoplasty; PK = penetrating keratoplasty; EK = endothelial keratoplasty.

See this image and copyright information in PMC

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Survey report on keratoplasty in China: A 5-year review from 2014 to 2018

Affiliations

Survey report on keratoplasty in China: A 5-year review from 2014 to 2018

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