title: Evolution of Corneal Transplantation in the Province of Quebec From 2000 to 2011.
abstract: OBJECTIVE
  The goal of this study was to determine the changes in surgical techniques and leading indications for corneal transplantations performed in the last decade. The impact of administrative changes of corneal banking in Quebec was also evaluated.
  
  
  METHODS
  The records of all corneal transplantations performed between January 2000 and December 2011 in the territory subserved by the Quebec Eye Bank and Héma-Québec (Quebec, Canada) were retrospectively reviewed.
  
  
  RESULTS
  A total of 3459 corneal transplantations were performed between 2000 and 2011. The rate of corneal transplantation more than doubled from 234 grafts per year in 2000 to 592 grafts per year in 2011. Imported tissue represented 40% of grafted corneas. Increases in tissue importation were seen in 2003 and 2009 to address local tissue shortage and peaks in wait time. The average wait time decreased from 434 ± 456 days (2000-2008) to 418 ± 551 days (2009-2011) (P = 0.01). The leading surgical indications were Fuchs endothelial corneal dystrophy (27%), pseudophakic corneal edema (26%), keratoconus (13%), and viral keratitis (8%). Regrafts represented 25% of procedures. Descemet stripping automated endothelial keratoplasty became the preferred technique for endothelial diseases, surpassing penetrating keratoplasty in 2011.
  
  
  CONCLUSIONS
  The surgical indications and techniques used for corneal transplantation in Quebec reflected those of the literature. However, long wait times and corneal tissue shortages mandated significant changes in the organization of the Quebec Eye Bank. Partnering with a larger agency responsible for tissue and blood donation coordination (Héma-Québec) had a positive impact on yearly transplantation rates and wait times.
authors.affiliation: *Department of Ophthalmology, Université de Montréal, Montreal, QC, Canada; †Department of Ophthalmology, Maisonneuve-Rosemont Hospital Research Center, Montreal, QC, Canada; ‡Department of Ophthalmology, Centre Hospitalier de l'Université de Montréal, Hôpital Notre-Dame, Montréal, QC, Canada; §Héma-Québec, Quebec, QC, Canada; and ¶Banque d'Yeux du Québec, Montreal, QC, Canada.
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Robert
authors.forename: Marie-Eve
authors.initials: ME
authors.lastname: Choronzey
authors.forename: Julie
authors.initials: J
authors.lastname: Lapointe
authors.forename: Louis-Pierre
authors.initials: LP
authors.lastname: Gauvin Meunier
authors.forename: Mona
authors.initials: M
authors.lastname: Harissi-Dagher
authors.forename: Marc
authors.initials: M
authors.lastname: Germain
authors.forename: Michèle
authors.initials: M
authors.lastname: Mabon
authors.forename: Isabelle
authors.initials: I
authors.lastname: Brunette
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003316:Corneal Diseases / Q000453:epidemiology*; D016039:Corneal Transplantation / Q000639:trends*; D005125:Eye Banks / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011792:Quebec / Q000453:epidemiology; D012086:Reoperation; D012189:Retrospective Studies; D014019:Tissue Donors / Q000706:statistics & numerical data; D066027:Transplant Recipients / Q000706:statistics & numerical data; D014850:Waiting Lists