title: Evolving surgical techniques of and indications for corneal transplantation in Ontario: 2000 - 2012.
abstract: OBJECTIVE
  To evaluate trends in indications for and preferred surgical techniques of corneal transplantation in Ontario over a 12-year period.
  
  
  METHODS
  Retrospective review of recipient information forms collected by Eye Bank of Canada (Ontario Division).
  
  
  METHODS
  Patients who received corneal transplantation in Ontario between 2000 and 2012, totaling 11,725 corneal transplants performed.
  
  
  METHODS
  Database containing information collected from recipient information forms maintained by the Eye Bank of Canada (Ontario Division) was reviewed. Corneal transplants performed between July 1, 2000, and June 30, 2012, in Ontario were analyzed. Surgeons complete recipient information forms at the time of corneal transplant surgery. Of the 11,725 available recipient information forms, 10,906 (93%) were sufficiently complete to meet the inclusion criteria and were included in the study.
  
  
  RESULTS
  Since 2009, Fuchs endothelial dystrophy overtook pseudophakic corneal edema as the leading indication for corneal transplantation. Since the shift toward lamellar keratoplasty in 2006, there has been a significant decrease in number of corneal transplants performed with penetrating keratoplasty (PKP; p = 0.0016) and a significant increase in Descemet stripping automated endothelial keratoplasty (DSAEK; p = 0.0069) and deep anterior lamellar keratoplasty (p = 0.0108). The gap between number of PKPs and DSAEKs performed each year is progressively narrowing. From July 1, 2011, to June 30, 2012, 514 PKPs were performed compared with 420 DSAEKs. From 2011 to 2012, 83% of corneal transplants indicated by Fuchs endothelial dystrophy were performed with DSAEK, whereas only 13% were performed with PKP.
  
  
  CONCLUSIONS
  Six years since initial implementation, partial thickness transplantation continues to increase in popularity. Corneal tissue supply and demand will need to reflect these changes in the field of corneal transplantation.
authors.affiliation: Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ont. azhang2015@meds.uwo.ca
authors.forename: Angela Qiao
authors.initials: AQ
authors.lastname: Zhang
authors.forename: Darya
authors.initials: D
authors.lastname: Rubenstein
authors.forename: Aryeh Joshua
authors.initials: AJ
authors.lastname: Price
authors.forename: Elie
authors.initials: E
authors.lastname: Côté
authors.forename: Max
authors.initials: M
authors.lastname: Levitt
authors.forename: Linda
authors.initials: L
authors.lastname: Sharpen
authors.forename: Allan
authors.initials: A
authors.lastname: Slomovic
mesh_terms: D000368:Aged; D003316:Corneal Diseases / Q000453:epidemiology* / Q000601:surgery*; D016039:Corneal Transplantation / Q000379:methods / Q000639:trends*; D016208:Databases, Factual; D005125:Eye Banks; D005260:Female; D006801:Humans; D008297:Male; D009864:Ontario / Q000453:epidemiology; D012189:Retrospective Studies