A preliminary descriptive analysis of Corneal Transplant Registry of National Eye Bank in India.
OBJECTIVE
To describe and analyze the Corneal Transplant Registry of National Eye Bank and also evaluate graft outcomes in India.


METHODS
All patients who underwent corneal transplant at our center within six months of setting up of Corneal Transplant Registry and installation of database at National Eye Bank were included in the study. The established database was analyzed for utilization, donor and recipient details and graft outcomes. Outcome was assessed at the end of one year follow up. The influence of various donor and recipient factors affecting outcome were evaluated. Visual outcome was analyzed in terms of shift in visual handicap category. Statistical tests like analysis of variance, Kruskal-Wallis test and Chi square tests were applied for determination of clinical significance wherever required.


RESULTS
326 corneas were received from 168 donors; of these, 234 (71.7%) were utilized for transplantation. Out of 177 patients with adequate (one year) follow up (75.6% patients), optical corneal replacement was performed in106 patients and therapeutic keratoplasty in71. 78% (82/106) patients in the optical group retained clear grafts at the end of follow up. 59.7% (49 of 82) of patients who attained clear grafts belonged to visual disability category 3 or worse pre-operatively. 59.1% of these achieved BCVA of ≥6/60 at the end of follow up; thus shifting up their visual handicap category. Primary graft failure was found to be associated with full thickness keratoplasty and not with lamellar procedures (p<0.05) and occurred in 4.2% patients (5) with optical corneal replacement whereas 7.5% patients (8) developed secondary graft failure. Age of donor (p=0.54), death enucleation time (p>0.05), cause of donor death (p=0.15), type of surgical procedures (p=0.538) and indication for surgery did not have any significant effect on outcome. 76% patients who underwent therapeutic graft achieved elimination of corneal infection.


CONCLUSIONS
The development of corneal graft registry established an effective means to evaluate our corneal transplantation services. Outcomes of sight restoring corneal transplants performed were comparable to results of graft registries from developed nations.
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Varun
V
Gogia
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Shikha
S
Gupta
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Jeewan Singh
JS
Titiyal
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Anita
A
Panda
Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.
Ravinder M
RM
Pandey
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. Electronic address: radhika_tan@yahoo.com.
Radhika
R
Tandon
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001766:Blindness / Q000453:epidemiology* / Q000601:surgery*; D016039:Corneal Transplantation / Q000706:statistics & numerical data*; D005125:Eye Banks / Q000706:statistics & numerical data*; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology*; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data; D010865:Pilot Projects; D015995:Prevalence; D012042:Registries; D012307:Risk Factors; D014019:Tissue Donors / Q000706:statistics & numerical data*; D016896:Treatment Outcome
Corneal transplantation; Eye Bank; Graft registry