Descemet's membrane endothelial keratoplasty is the predominant keratoplasty procedure in Germany since 2016: a report of the DOG-section cornea and its keratoplasty registry

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Elias Flockerzi - , Saarland University (Author)
  • Christina Turner - , Saarland University (Author)
  • Berthold Seitz - , Saarland University (Author)
  • Ge Ke R.Study Group Collaborators - , Saarland University (Author)

Abstract

Background/aims: This retrospective multicentric panel study provides absolute numbers, types of and indications for corneal transplantation in Germany from 2011 to 2021 and sets them into the international context. Methods: A questionnaire was sent to the 104 German ophthalmologic surgery departments and 93 (89%) provided their data. Results: The number of reported keratoplasties more than doubled from 2011 (n=4474) to 2021 (n=8998). Lamellar keratoplasties (49% posterior (n=2883), 4% anterior (n=231)) surpassed penetrating keratoplasty (PKP, 47%, n=2721) for the first time in 2014. Since 2016, Descemet's membrane endothelial keratoplasty (DMEK) has become the predominant keratoplasty procedure in Germany. Its number increased by 1.5-fold from 3850 (2016) to 5812 (2021). Main indications in 2021 were Fuchs' endothelial corneal dystrophy (FECD, 43%), pseudophakic corneal decompensation (12%), repeated keratoplasty (11%), infections (7%), keratoconus (6%) and corneal scarring (4%, others: 9%). The PKP percentage decreased from 70.2% in 2011 (n=3141) to 31.7% in 2021 (n=2853). Descemet's stripping (automated) endothelial keratoplasties (DSAEKs) decreased to 1% in 2021 (n=74). 98.6% of all posterior lamellar keratoplasties were DMEKs in Germany in 2021. The number of deep anterior lamellar keratoplasties (DALKs) remained comparable from 2011 (n=269) to 2021 (n=251, 2.8%). Conclusion: Main indications for corneal transplantation in Germany (2021) were FECD and pseudophakic corneal decompensation. DMEK is by far the predominant corneal transplantation procedure since 2016 followed by PKP, whose absolute number decreased only slightly during the decade from 2011 to 2021. DALK proportions remain low, but stable, whereas DSAEK decreased annually and plays a minor role in Germany. Trial registration number: NCT03381794.

Details

Original languageEnglish
Article numberbjo-2022-323162
JournalBritish journal of ophthalmology
Publication statusAccepted/In press - 16 Aug 2023
Peer-reviewedYes
Externally publishedYes

External IDs

PubMed 37586835

Keywords

Keywords

  • cornea, treatment surgery