title: Correlation of clinical and pathologic diagnoses of corneal disease in penetrating keratoplasties in Vancouver: a 10-year review.
abstract: OBJECTIVE
  The objectives of the present study were: (i) to examine the leading clinical indications and pathologic diagnoses of penetrating keratoplasties in Vancouver, BC; and (ii) to evaluate the correlation between the clinical and pathologic diagnoses.
  
  
  METHODS
  Retrospective chart review of all pathologic records of corneal tissue submitted to the Department of Pathology & Laboratory Medicine, Vancouver General Hospital, during an 11-year period.
  
  
  METHODS
  For each penetrating keratoplasty, information regarding the clinical indication and pathologic features identified on histopathologic analysis was compiled.
  
  
  RESULTS
  The top 5 clinical indications for transplant were failed graft (21%); bullous keratopathy (20%); keratoconus (17%); scarring, with or without inflammation (14%); and Fuchs dystrophy (11%). The top 5 pathologic diagnoses corresponded to these clinical diagnoses. In the majority of cases, there was agreement between clinical and pathologic diagnoses; however, in 6% of records, the clinical and pathologic diagnoses did not correlate. This situation occurred most often when considering grafts with clinical diagnoses of bullous keratopathy, Fuchs dystrophy, or keratoconus. A review of the grafts with infectious keratitis illustrated the potential for histopathologic evaluation of corneal buttons to identify unsuspected infectious agents.
  
  
  CONCLUSIONS
  Routine histopathologic evaluation of penetrating keratoplasty clarifies the clinical diagnosis in a proportion of cases and aids in identifying infectious agents.
authors.affiliation: Department of Ophthalmology & Visual Sciences, Vancouver General Hospital and University of British Columbia, Vancouver, BC. claires@interchange.ubc.ca
authors.forename: Claire A
authors.initials: CA
authors.lastname: Sheldon
authors.forename: J Martin
authors.initials: JM
authors.lastname: McCarthy
authors.forename: Valerie A
authors.initials: VA
authors.lastname: White
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001955:British Columbia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003315:Cornea / Q000473:pathology*; D003316:Corneal Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D015948:Keratoplasty, Penetrating / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D055815:Young Adult