Analysis of Causes for Penetrating Keratoplasty in a Hospital in Qingdao

Objective: To analyze the causes and identify trends of penetrating keratoplasty (PKP) over the past 10 years. Methods: This was a retrospective case series study. Medical records of patients who underwent PKP at Qingdao Eye Hospital from January 2013 to December 2017 were collected, and the data was compared to that from the 2005 to 2010 period at the same hospital. Data of patients, including age, sex, and preoperative primary diagnosis for PKP were reviewed. The proportion of the different causes for PKP during 2005-2010 and 2013-2017 was statistically analyzed with a Chi-square test. Results: PKPs were performed on 855 cases from 2013 to 2017. The top four causes were suppurative keratitis (303 cases, 35.4%), regraft (132 cases, 15.4%), keratoconus (130 cases, 15.2%), and herpes keratitis (115 cases, 13.5%). PKPs were performed on 875 cases from 2005 to 2010. The top four causes for PKP were suppurative keratitis, herpes keratitis, keratoconus, and bullous keratopathy. Suppurative keratitis was the first causes for PKP during both periods in 2005-2010 and 2013-2017, and the proportion of the causes for PKP was not significantly different (χ2=0.543, P=0.461). Regraft increased as the second causes for PKP during 2013 to 2017 (χ2=33.294, P<0.001). Keratoconus remained in third place, but the proportion of PKP increased from 2013-2017 compared to 2005-2010 (χ2=6.061, P=0.014). The proportion of herpes keratitis decreased from the second causes during 2005-2010 to the fourth causes during 2013-2017 (χ2=6.397, P=0.011). Conclusion: Suppurative keratitis was the leading causes of PKP at Qingdao Eye Hospital from 2013 to 2017, followed by regraft, keratoconus and herpes keratitis. Compared to 2005-2010, the proportions of regraft and keratoconus increased significantly in 2013-2017 at Qingdao Eye Hospital, while the proportion of herpes keratitis decreased. Key words: penetrating keratoplasty; retrospective study; corneal diseases