Corneal transplant registry informs future eye surgery

An innovative vision-restoring procedure has been reported on in detail for the first time, assisting surgeons to make important decisions when using corneal grafts to treat thousands of Australians facing blindness each year.

The findings form part of the 2018 report of The Australian Corneal Graft Registry (ACGR), which collects and analyses national data relating to corneal transplants. Established at Flinders University in 1985, the registry is one of the world’s largest repositories of information on corneal transplants, having collected data on more than 35,000 graft procedures and enabled many advances to be made in the field of ophthalmology.

Corneal grafting, or keratoplasty, involves the replacement of the very front clear ‘window’ section of the eye with a cornea from a deceased donor. Corneal damage from genetic conditions, infections or traumatic injuries is one of the major causes of blindness in Australia.

“The newer procedure, called Descemet’s Membrane Endothelial Keratoplasty, involves replacing only a very thin internal layer of the cornea,” said Associate Professor Richard Mills, Medical Director of the ACGR. “It requires fewer stitches and is often commended for potentially reduced rates of graft rejection and enabling final vision outcomes to be reached in a shorter time.

“However, there are aspects which can make these techniques more complex to perform. This can lead to higher rates of early failure. It is therefore important that both the short- and long-term outcomes are documented for surgeons to weigh up the pros and cons of these surgeries for patients’ particular needs.”

Associate Professor Mills said the registry’s major reports are always enthusiastically received by the ophthalmic community. He noted, “Given the immense amount of data the registry holds and its longitudinal nature — with patient outcomes analysed over decades — the reports are regarded as a vital source of information on the different types of keratoplasty performed in Australia.”

The registry has played a key role in reducing the time Australians need to wait for sight-restoring transplants by overturning previous beliefs that cornea donors have to be young. Its knowledge has also led to other countries establishing registries based on the Flinders University model, and Flinders’ data is often used in international comparative studies investigating improved corneal transplants.

The registry recently received a grant from the Australian Government’s Organ and Tissue Authority (DonateLife) of approximately $500,000 to ensure its continued operation for the next two years.

Image credit: ©stock.adobe.com/au/Yuganov Konstantin