Abstract
Aims The aim of this study was to examine the outcomes of corneal transplantation in cases performed by a group of general ophthalmologists and those performed by an ophthalmologist with a subspecialist interest in corneal surgery.
Methods A retrospective analysis of the outcomes in corneal transplantation was carried out for a 4-year period in three separate units in South Wales. In addition to patient demographic details, the primary diagnosis, type of keratoplasty performed, and outcome of surgery were noted. The data were analysed statistically by the Mann–Whitney U-test (one-tailed).
Results Group A (n=35) was defined as those patients whose surgery was performed by a general ophthalmologist. There were seven surgeons in this group with a mean of five procedures each over the study period. Group B (n=54) were all operated on by the same surgeon. The mean age in both groups was similar with group A comprising of 66% males with 50% males in group B. The commonest indication for surgery in both groups was endothelial cell failure In group A, graft clarity at 1 year was 83% for all aetiologies and 73% at 2 years. In group B, the results were 97 and 92%, respectively. In group A, overall 56% achieved 6/18 or better compared with 68% in group B. In group A 73% had an improvement of one or more lines compared with 84% in group B (P=0.085). Reasons for graft failure in both groups were similar.
Conclusion The success rate of corneal transplantation carried out by general ophthalmologists in this study is reduced when compared with cases performed by a corneal surgeon. The explanation for this is not clear, but is undoubtedly multifactorial.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Tullo AB, Dyer PA . Corneal transplantation in Britain. BMJ 1995; 310(6991): 1347–1348.
Smith RE, McDonald HR, Nesburn AB, Minckler DS . Penetrating keratoplasty: changing indications, 1947–1978. Arch Ophthalmol 1980; 98(7): 1226–1229.
Brady SE, Rapuano CJ, Arentsen JJ, Cohen EJ, Laibson PR . Clinical indications for and procedures associated with penetrating keratoplasty, 1983–1988. Am J Ophthalmol 1989; 108(2): 118–122.
Arentsen JJ, Morgan B, Green WR . Changing indications for keratoplasty. Am J Ophthalmol 1976; 81(3): 313–318.
Ramsay AS, Lee WR, Mohammed A . Changing indications for penetrating keratoplasty in the west of Scotland from 1970 to 1995. Eye 1997; 11(Part 3): 357–360.
United Kingdom Transplant Support Service Authority. Statistics Prepared by UK Transplant Support Service Authority from the National Transplant Database Maintained on Behalf of the UK Transplant Community. UKTSSA: Bristol, 1999.
Long J, Walsh D, Ritchie DA, Russell F . Corneal donation in the accident and emergency department: observational study. BMJ 2000; 321(7271): 1263–1264.
Carney LG, Jacobs RJ . Problems remaining after successful keratoplasty for keratoconus. Clin Exp Optom 1989; 72: 22–25.
Vail A, Gore SM, Bradley BA, Easty DL, Rogers CA, Atmitage WJ . Conclusions of the corneal transplant follow up study. Br J Ophthalmol 1997; 81: 631–636.
Williams KA, Roder D, Esterman A, Muehlberg SM, Coster DJ . Factors predictive of corneal graft survival: report from the Australian Corneal Graft Registry. Ophthalmology 1992; 99: 403–414.
Acknowledgements
We thank the surgeons in the Royal Gwent Hospital, Newport and Singleton Hospital, Swansea for their permission to involve their patients in this study.
Author information
Authors and Affiliations
Corresponding author
Additional information
Poster presentation, Royal College of Ophthalmologists Annual Congress, Manchester 2002
Rights and permissions
About this article
Cite this article
Teenan, D., Sim, K. & Hawksworth, N. Outcomes of corneal transplantation: a corneal surgeon vs the general ophthalmologist. Eye 17, 727–730 (2003). https://doi.org/10.1038/sj.eye.6700486
Received:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/sj.eye.6700486


