[Penetrating keratoplasty in Iceland 1981-1996.]

Penetrating keratoplasties have been performed in Iceland since 1981 and are the only type of organ transplantation done in the country. Previous studies have shown that Iceland differs from most other countries in regard to indications for penetrating keratoplasty.

The files of all patients who underwent penetrating keratoplasty from 1981 to 1st of January 1996 were reviewed.

During the period 99 penetrating keratoplasties were performed on 94 eyes in 76 patients, age five to 94 years. Penetrating keratoplasty was most commonly performed on 30-39 years old. The most frequent indications were macular corneal dystophy (35%), pseudophakic bullous keratopathy (13%) and keratoconus (10%). Fresh donor corneas were 73 and 26 cultured. The mean visual acuity with correction, measured with a Snellen chart was 0.15 preoperatively but 0.46 at six months postoperatively and 0.53 at 18 months postoperatively. The most common complications were graft rejection and infection.

The annual number of penetrating keratoplasties per 100 thousand inhabitants is approximately the same in Iceland and the UK but significantly lower than in the USA. Macular corneal dystrophy is a common indication in Iceland contrary to other countries, accounting for more than a third of all grafts, which again may explain the favorable outcome of grafts in this study as measured by visual acuity.