title: New Zealand trends in corneal transplantation over the 25 years 1991-2015.
abstract: To report the 25-year longitudinal trends in indications and corneal transplantation techniques in New Zealand.
  
  
  
  Statistical analysis of prospectively acquired New Zealand National Eye Bank (NZNEB) electronic database from 1991 to 2015 inclusive. Subjects were recipients of corneal transplants in 62 centres supplied by the NZNEB. Main outcome measures were indications, recipient age and transplantation techniques.
  
  
  
  From January 1991 to December 2015, NZNEB supplied tissue for 5574 corneal transplants, increasing annually from 89 (1991) to 290 (2015). Penetrating keratoplasty remained the most commonly performed technique throughout the 25-year period, although it decreased from 98.9% of all transplants in 1991 to 60.3% in 2015. There was a corresponding increase in deep anterior lamellar and endothelial keratoplasty over the most recent decade from 2.5% to 7.2% and 4.9% to 31.4%, respectively. Keratoconus remained the leading indication for keratoplasty through to 2015 (34.5%). Regrafts (23.1%) and Fuchs endothelial corneal dystrophy (17.0%) have become more common indications, while bullous keratopathy has become less common (10.8%). There was a bimodal distribution in age with peaks at 20-29 and 60-79 years. There was a reduction in recipients under age 40 and corresponding increase in the percentage of recipients aged 40-69.
  
  
  
  Changing indications and increasing uptake of lamellar keratoplasty have been significant international trends over the last 25 years. However, New Zealand's corneal disease and population characteristics create unique longitudinal trends, with keratoconus remaining the leading indication and penetrating keratoplasty the leading technique from 1991 to 2015.
authors.affiliation: Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
authors.forename: Bia Z
authors.initials: BZ
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
authors.forename: Jay J
authors.initials: JJ
authors.lastname: Meyer
authors.affiliation: New Zealand National Eye Bank, Department of Ophthalmology, University of Auckland, Auckland, New Zealand.
authors.forename: Nigel H
authors.initials: NH
authors.lastname: Brookes
authors.affiliation: New Zealand National Eye Bank, Department of Ophthalmology, University of Auckland, Auckland, New Zealand.
authors.forename: S Louise
authors.initials: SL
authors.lastname: Moffatt
authors.affiliation: New Zealand National Eye Bank, Department of Ophthalmology, University of Auckland, Auckland, New Zealand.
authors.forename: Helen C
authors.initials: HC
authors.lastname: Twohill
authors.affiliation: Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.|New Zealand National Eye Bank, Department of Ophthalmology, University of Auckland, Auckland, New Zealand.
authors.forename: David G
authors.initials: DG
authors.lastname: Pendergrast
authors.affiliation: Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.|New Zealand National Eye Bank, Department of Ophthalmology, University of Auckland, Auckland, New Zealand.
authors.forename: Trevor
authors.initials: T
authors.lastname: Sherwin
authors.affiliation: Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.|New Zealand National Eye Bank, Department of Ophthalmology, University of Auckland, Auckland, New Zealand.
authors.forename: Charles N J
authors.initials: CNJ
authors.lastname: McGhee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003316:Corneal Diseases / Q000453:epidemiology / Q000601:surgery*; D016039:Corneal Transplantation / Q000639:trends*; D005125:Eye Banks / Q000706:statistics & numerical data; D005260:Female; D005544:Forecasting; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D009520:New Zealand / Q000453:epidemiology; D011446:Prospective Studies; D055815:Young Adult
keywords: Cornea; Epidemiology; Eye (Tissue) Banking; Treatment Surgery