Evolving Indications for Corneal Transplantation and Trends in Surgical Techniques in Iran from 2006 to 2013; an Eight-Year Review

To report the evolving indications for keratoplasty and the shift in the technique of keratoplasty performed in Iran over an 8-year period.
This was a retrospective database review of 47,129 records of corneal transplant tissues at the Central Eye Bank of Iran, from March 2006 to March 2013. The patient demographics, indications, and techniques of corneal transplantation performed were analyzed.
The six leading indications were keratoconus (KCN, n= 21,350 eyes, 45.3%), followed by bullous keratopathy (BK, n= 8,566 eyes, 18.2%), corneal opacity and scar (COS, n= 7,158 eyes, 15.2%), graft failure (n= 3,252 eyes, 6.9%), corneal dystrophies (n= 2,553 eyes, 5.4%), and infectious keratitis (n=2,238 eyes, 4.7%). Penetrating keratoplasty (PKP) accounted for 71.0% (n=33,476) of all keratoplasties performed. Since the introduction of Descemet stripping automated endothelial keratoplasty (DSAEK) in Iran in 2008, there was a significant increase in the number of DSAEK (P KCN is still the leading indication for keratoplasty in Iran, with no significant change of trend over the 8-year period. There was an increasing trend in the rate of DSAEK while PKP demonstrated a decreasing trend; which indicates a shift from PKP to DSAEK performed for corneal endothelial disorders.