Changing Indications for Penetrating Keratoplasty in Bahrain in a Tertiary Referral Centre

• Main Authors: Al-Yousuf N, Al Alawi E, Mahmood A, Alzayani A, Al Sawad H, Alsetri H, Al-Mousawi J, Ali K, Al Khayat M, Naser R
• Format: Article
• Language: English
• Published: Dove Medical Press 2021-04-01
• Series: Clinical Ophthalmology
• Subjects: keratoconus; bullous keratopathies; corneal graft; indications; cornea transplant; trachoma
• Online Access: https://www.dovepress.com/changing-indications-for-penetrating-keratoplasty-in-bahrain-in-a-tert-peer-reviewed-article-OPTH

Nada Al-Yousuf,1 Ebtisam Al Alawi,2 Abdulhameed Mahmood,3 Amani Alzayani,4 Hajer Al Sawad,4 Hasan Alsetri,5 Jalal Al-Mousawi,6 Khatoon Ali,4 Maryam Al Khayat,4 Reem Naser4 1Department of Ophthalmology, King Abdulla Medical City, Manama, Bahrain; 2The Eye Center, Manama, Bahrain; 3Department of Ophthalmology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia; 4Department of Ophthalmology, Salmaniya Medical Complex, Manama, Bahrain; 5Department of Chemistry and Biochemistry, University of California, Los Angeles, CA, USA; 6Al-Mousawi Specialist Center, Manama, BahrainCorrespondence: Nada Al-YousufDepartment of Ophthalmology, King Abdulla Medical City, P.O. Box 26671, Adliya, BahrainTel [phone]Fax [phone]Email [e-mail]: To study the changing indications for Penetrating keratoplasty in Bahrain and to compare them with published data.Patients and Methods: A Retrospective review of available records of patients who underwent penetrating keratoplasty at a tertiary center in Bahrain (1996− 2015). The trend of each indication was analyzed. The study was subdivided into three periods for correlation purposes. Pearson Coefficient r and the p values were used for interpretation of data. The results were compared with similar studies.Results: A total of 298 patients underwent keratoplasty in the study period, which is from 1996 until 2015 (missing data 2009– 2011). Keratoconus was found to be the leading indication, accounting for 33% of the total cases, followed by trachoma 27%, followed by aphakic and pseudophakic bullous keratopathies 13%. Trachoma showed a statistically significant decreasing trend (p < 0.001), Keratoconus had an increasing trend (p< 0.001). Bullous keratopathy showed an increasing trend (p = 0.001) with an abrupt rise after 2012.Conclusion: Corneal scarring due to old trachoma was the leading indication for keratoplasty 20 years ago in Bahrain. However, due to improvement of health awareness, hygiene, and the socioeconomic status, this has regressed with keratoconus becoming the leading indication from 2002 onwards. A surge of bullous keratopathy was noted after 2012, placing it as the second commonest indication. This may be due to the introduction of phacoemulsification technique for cataract surgery, and perhaps because the nature of the institute being a teaching hospital. Keratoconus is the leading indication and showed an increasing trend. It is recommended to perform a keratoconus screening program for early detection and prevention.Keywords: keratoconus, bullous keratopathies, corneal graft, indications, cornea transplant, trachoma