title: Indications for keratoplasty in Nepal: 2005 - 2010.
abstract: BACKGROUND
  Corneal disease, especially infective keratitis, is one of the major causes of visual impairment and blindness in developing countries.
  
  
  OBJECTIVE
  To find out the current indications for keratoplasty, how these indications have changed over time as well as how they are different from those in other parts of the world.
  
  
  METHODS
  A retrospective study of a case series of 645 keratoplasty surgeries (589 patients) was conducted at the Tilganga Institute of Ophthalmology from January 2005 to December 2010.
  
  
  METHODS
  The cases were evaluated in terms of demographic parameters, preoperative diagnosis and the type of surgery performed.
  
  
  RESULTS
  The most common indication for surgery was active infectious keratitis (264 eyes, 40.9 %), followed by corneal opacity (173 eyes, 26.8 %), regraft (73 eyes, 11.2 %), bullous keratopathy (58 eyes, 9.0 %), keratoconus (45 eyes, 7.0 %) and corneal dystrophy (11 eyes, 1.7 %). The mean recipient age was 41.7 ± 19.9 years with over a half of the patients between 15 to 49 years of age. More men (64.1 %) underwent keratoplasty than women (35.8 %). 59.8 % of the eyes with infectious keratitis had a perforated corneal ulcer. 49.7 % of corneal opacities were due to previous infectious keratitis. 72 % of regrafts were for endothelial failure of various causes. In older patients (> 50 years), bullous keratopathy was an important indication, after infectious keratitis. Keratoconus and corneal scar were major causes of keratoplasty in children of 14 years or less. Four percent of the patients had keratoplasty in both the eyes. 17.1 % of the patients who had one eye operated on had a blind fellow eye with a vision of less than 3/60.
  
  
  CONCLUSIONS
  Currently, keratitis, either active or healed, is the major indication for keratoplasty, suggesting that improved primary eye health care is necessary to decrease the prevalence of corneal blindness.
authors.forename: L
authors.initials: L
authors.lastname: Bajracharya
authors.forename: R
authors.initials: R
authors.lastname: Gurung
authors.forename: E H
authors.initials: EH
authors.lastname: Demarchis
authors.forename: M
authors.initials: M
authors.lastname: Oliva
authors.forename: S
authors.initials: S
authors.lastname: Ruit
authors.forename: G
authors.initials: G
authors.lastname: Tabin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003318:Corneal Opacity / Q000453:epidemiology* / Q000601:surgery*; D016039:Corneal Transplantation / Q000706:statistics & numerical data* / Q000639:trends; D003906:Developing Countries; D005260:Female; D006801:Humans; D007223:Infant; D007634:Keratitis / Q000453:epidemiology* / Q000601:surgery*; D007640:Keratoconus / Q000453:epidemiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009390:Nepal / Q000453:epidemiology; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data; D012189:Retrospective Studies; D055815:Young Adult