Keratoplasty in the United States: A 10-Year Review from 2005 through 2014

Ophthalmology. 2015 Dec;122(12):2432-42. doi: 10.1016/j.ophtha.2015.08.017. Epub 2015 Sep 19.


Purpose: To report evolving indications and preferred techniques of corneal transplantation in the United States.

Design: Retrospective review.

Methods: Annual reports from the Eye Bank Association of America on corneal graft distribution in the United States from 2005 through 2014 were reviewed.

Main outcome measures: Number and percentage of corneal grafts distributed for various types of keratoplasty and their surgical indications in the United States.

Results: The total number of corneal transplants increased from 44 277 in 2005 to 46 513 in 2014. In the past decade, penetrating keratoplasty dramatically decreased (from 95% to 42%) and largely has been replaced by various lamellar keratoplasty (LK) techniques (from 5% to 58%). Descemet stripping (automated) endothelial keratoplasty was the most common (50%) type of corneal transplantation performed in the United Stated in 2014. The volume of Descemet membrane endothelial keratoplasty (DMEK) has been doubling every year since 2011 and accounted for 11% of total endothelial keratoplasties in 2014. There was a significant shift in indication for corneal transplantation, with Fuchs' endothelial dystrophy (22%) being the most common, followed by corneal edema occurring after cataract surgery (12%) in 2014. Eye banks supplied precut corneal grafts for 68% of LK techniques in 2014.

Conclusions: In the United States, there has been a major shift in preferred keratoplasty techniques over the past decade, with a wide adoption of new LK techniques.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Corneal Diseases / surgery*
  • Corneal Transplantation / statistics & numerical data
  • Corneal Transplantation / trends*
  • Descemet Stripping Endothelial Keratoplasty / statistics & numerical data
  • Descemet Stripping Endothelial Keratoplasty / trends
  • Eye Banks / statistics & numerical data
  • Humans
  • Keratoplasty, Penetrating / statistics & numerical data
  • Keratoplasty, Penetrating / trends
  • Retrospective Studies
  • Tissue and Organ Procurement / statistics & numerical data
  • United States / epidemiology