Study of a single eye bank. Characteristics and progression of corneal transplantation from 2016 through 2022 in Galicia (Spain)

Objective

To describe the characteristics of donated and transplanted corneas, trends in surgical techniques, and indications for corneal transplantation, and the impact of COVID-19 on a Spanish tissue bank from 2016 through 2022.

Methods

We conducted a retrospective analysis of corneal donation records from Complejo Hospitalario Universitario de A Coruña Cryobiology Unit and Tissue Bank from January 1st, 2016 through June 30th, 2022.

Results

Corneal donations and transplants remained stable over 6.5 years, except for declines in 2020–2021. A total of 44.3% of all donated corneas were not transplanted, mainly due to tissue viability issues (41.4%). Donors averaged 60.2 ± 13 years, with a mean corneal endothelial cell count of 2701.3 ± 324.6 cells/mm² and a mean corneal clear zone diameter of 7.7 ± 0.7 mm. The preferred preservation method for keratoplasty was hypothermia (85,9%). Indications included endothelial dysfunction (53.8%), repeated keratoplasty (18.8%), corneal ectasia (15.4%), stromal opacity (7.6%), and tectonic causes (4.9%). Penetrating keratoplasty (PK) was more common (56.3%) than lamellar techniques (43.7%), but endothelial keratoplasty (EK) increased by 27.8% since 2019. EK, predominantly Descemet Membrane Endothelial Keratoplasty (DMEK, 94.1%), was used in 96.7% of endothelial dysfunction cases, although 28.6% were treated with PK. Deep anterior lamellar keratoplasty was primarily used for corneal ectasia (46.8%).

Conclusions

The Galicia Tissue Bank exceeds the European Eye Bank Association quality standards. Penetrating techniques remain predominant, but the trend is towards favor lamellar procedures, particularly DMEK. Endothelial dysfunction is the leading and growing indication for corneal transplantation.