Changing indications for penetrating keratoplasty: a newly developed country's experience.
OBJECTIVE
To study the changing indications for penetrating keratoplasty in Singapore and compare local indications with developed countries with established corneal graft programs.


METHODS
A descriptive study of all penetrating keratoplasty cases performed in the Singapore National Eye Center over a 5 year period, from 1 January 1991 to 31 December 1995 using records of the Singapore Eye Bank registry.


RESULTS
A total of 327 penetrating keratoplasties were performed. Bullous keratopathy was the indication in more than a quarter of all cases (26.3%). Aphakic bullous keratopathy (11.6%) and pseudophakic bullous keratopathy (11.3%) accounted for the majority of the bullous keratopathy cases. The other leading indications were regrafts (11.9%), corneal dystrophies (10.4%), traumatic scarring (10.1%) and keratoconus (9.8%). A higher proportion of aphakic and pseudophakic bullous keratopathy as well as regrafts was noted in this series compared to a previous report on corneal transplantation in the 1980s. A rising indication rate of pseudophakic bullous keratopathy, in conjunction with a declining indication rate of herpetic keratitis was observed over the 5 year study period.


CONCLUSIONS
The indications for penetrating keratoplasty in Singapore appear to follow the trend seen in developed Western countries over the past few decades.
Wong
T Y
TY
Singapore National Eye Center, Singapore.
Chan
C
C
Lim
L
L
Lim
T H
TH
Tan
D T
DT
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003315:Cornea / Q000601:surgery*; D003316:Corneal Diseases / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D015948:Keratoplasty, Penetrating / Q000379:methods / Q000639:trends; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D012846:Singapore; D016896:Treatment Outcome