National Survey on Corneal Transplantation in Japan.

Purpose: To report the results of a national survey on corneal transplantation in Japan.

Methods: The Japan Cornea Society and the Keratoplasty Society of Japan conducted a national survey on corneal transplantation performed from 2017 to 2019. Data from various institutions were collected through an online database and subsequently analyzed.

Results: In total, 4951 cases from 44 facilities were documented. The leading cause of corneal transplantation was corneal edema (CE), which accounted for 39.3% of cases, followed by repeat keratoplasty at 27.7%. Among CE cases, postcataract surgery was the most prevalent (25.1%), followed by postglaucoma surgery (20.8%) and laser iridotomy-induced CE (18.2%). Fuchs endothelial corneal dystrophy was the fourth most common cause (10.9%). Regarding surgical methods, Descemet stripping automated endothelial keratoplasty was the most common, used in 41.3% of procedures, followed by penetrating keratoplasty at 37.1%. Deep anterior lamellar keratoplasty and Descemet membrane endothelial keratoplasty were used in 8.1% and 2.6% of cases, respectively. One year after transplantation, graft clarity was maintained in 80.5% of cases, and regrafting was necessary in 15.2% of instances.

Conclusions: The national survey reveals that CE is the most frequent indication for corneal transplantation in Japan. Increases in cases from glaucoma surgery and Fuchs endothelial corneal dystrophy were noted among patients with CE. Endothelial keratoplasty, especially Descemet stripping automated endothelial keratoplasty, is now the preferred surgical technique for these transplants.