Indications and Outcomes of Corneal Transplant Surgery in Ghana

Background: Corneal blindness contributes to 25% of all blindness. We review corneal transplant, a common surgical remedy, in Ghana to determine indications and visual outcomes in resource-poor environments. Methods: A retrospective cross-sectional study of keratoplasty evaluating indications, pre- and postoperative outcomes complications and  their associations, between January 2014 and December 2018 at a teaching  hospital in Ghana. Descriptive statistics and McNemar’s test were used for the analyses. Results: Seventy-five eyes were studied. The mean ± standard deviation (SD) age of patients was 45.08 ± 17.85 years, the majority being 20–39 years (58.7% were male). Pseudophakia bullous keratopathy (PBK) was the commonest indication for keratoplasty (26.7%) followed by keratoconus (21.3%). Preoperatively 96% of eyes were blind with vision <3/60 with 64% out of the total eyes with vision <1/60. Postoperatively, 60% of all grafts had uncorrected vision of 3/60 or better after the last follow-up. McNemar’s test revealed a statistically  significant difference between postsurgical and pre-surgical visual acuity (VA) (p < 0. 001). The median follow-up period was 12 months. The commonest postsurgical complication was raised intraocular pressure (IOP) (22.7%) with a total of 14.7% of grafts failures. Conclusion: In this setting, PBK is the leading indication for corneal transplant. Visual outcomes for corneal transplant in this  resource poor area are not worse than in other settings. We need to pay attention to corneal transplant services to cater for the expected increase  in PBK from the increasing cataract surgical rate.