Trends of penetrating keratoplasty in the United States from 1980 to 2004

Purpose: To examine the changing trends in penetrating keratoplasties (PKs) performed in the United States. Design: Retrospective review. Methods: Review of Eye Bank Association of America (EBAA) data on corneal tissue distribution in the United States from 1980 to 2004. Data analysis was retrospective. United States population census data were obtained and used for population-adjusted calculations. A series of Poisson regression models were calculated looking at the temporal trends over time. Main Outcome Measures: The estimated yearly percent change and P values were calculated using Poisson regression models. Results: The total number of corneas distributed for PKs from EBAA member eye banks have steadily increased since 1980. In 1990, the international and domestic distribution data were separated. The total number of PKs performed from EBAA-supplied tissue has continued to rise since 1990; however, the total number of PKs performed in the United States has steadily declined and when population-adjusted rates are examined, the rate of decline is more dramatic. Conclusion: Although both absolute numbers and age-adjusted numbers of PKs have declined recently, the population-adjusted rates have dropped more significantly.