A survey of corneal graft practice in the United Kingdom

A questionnaire designed to survey current corneal graft practice was sent to 498 consultant ophthalmologists in the United Kingdom. Three hundred and twenty-nine completed questionnaires (66%) were returned. Seventy per cent of these were from consultants who perform corneal grafts, of whom 36% had a specialist interest in corneal surgery. The survey found that most consultants preferred to perform corneal grafts on an inpatient basis with the patient under general anaesthesia. Agreement (> 80%) was also found in the following areas: use of a hand-held trephine, concurrent cataract surgery (if indicated), post-operative immunosuppression, and refraction to assess post-operative astigmatism. There was less agreement on the choice of donor material, use of tissue matching, donor-trephine size disparity, suture technique, relative timing of trabeculectomy surgery (if required), the management of intraocular lenses during surgery for pseudophakic bullous keratopathy, timing of discharge after surgery, use of prophylactic acyclovir, management of astigmatism, routine removal of all corneal sutures, and discharge of uncomplicated cases from routine follow-up.