CHAPTER 15

Clinical Approach to Corneal Transplantation

Corneal Transplantation

Corneal transplantation refers to surgical replacement of a full-thickness or lamellar portion of the host cornea with that of a donor eye. If the donor is another person, the procedure is called an allograft; use of donor tissue from the same or fellow eye is called an autograft (see the section Corneal Autograft Procedures). In 2011, 46,196 corneal transplants were performed in the United States, representing an 8.3% increase from the previous year. The number of full-thickness or penetrating keratoplasties (PKs) has decreased every year for the past 6 years; in 2011, 21,620 PKs were performed. By contrast, the number of endothelial keratoplasties (EKs) has increased significantly each year, to 21,555 procedures performed in 2011. The vast majority were Descemet stripping endothelial keratoplasty (DSEK), and a small number (344) were Descemet membrane endothelial keratoplasty (DMEK). There were 932 anterior lamellar keratoplasty (ALK) procedures in 2011. The majority were deep anterior lamellar keratoplasty (DALK) for keratoconus; however, most patients with keratoconus are still being treated with PK (over 7000 in 2011). See Table 15-1, which lists indications for transplantation of tissue from US eye banks for procedures performed in the United States and internationally.

Table 15-1