VIENNA, Austria — The main indications for corneal transplantation in Asia differ dramatically from those of the Western world, but a similar shift from penetrating keratoplasty to selective lamellar procedures has been observed in recent years, according to one speaker here.
“While the main indications for corneal transplantation in the Western world are keratoconus, bullous keratopathy and Fuchs’ dystrophy, Asia has a much higher prevalence of keratitis, both infectious and fungal, corneal scars, late-stage endothelial disease and allograft rejection,” Donald Tan, MD, said at the EuCornea meeting here preceding the European Society of Cataract and Refractive Surgeons meeting.
Looking at the relative percentage of PK, anterior lamellar procedures and endothelial grafting, it becomes apparent that deep anterior lamellar keratoplasty is generally on the increase.
“It could potentially replace PK in almost a third of our indications for graft surgery in Asia,” Dr. Tan said.
However, differences between countries can be great. Developing Asian countries such as India and Thailand are adopting the anterior lamellar approach, mainly for corneal scars and infections, but are slow to adopt endothelial keratoplasty due to lack of donor preparation resources. In more Westernized areas of the continent, endothelial procedures now represent a high proportion of transplantation procedures, up to 36% in Singapore and 60% in Japan, Dr. Tan said.