MMed, Ophthalmology, Faculty of Health Sciences, University of the Witwatersrand, 2009 / Aim: To describe and analyse donor demographics; source, utilisation and distribution of corneal
tissue procured by the Gauteng cornea and eye bank (GCEB). To further establish the indications
for penetrating keratoplasty done by private ophthalmologists in Johannesburg.
Methods: A retrospective study of the records from the GCEB for the 8 year period from 1998 to
2005. An analysis for each year was done in respect of donor demographics; corneal donor tissue
source and distribution. Records from selected corneal surgeons in private practice in
Johannesburg were analysed for indications for penetrating keratoplasty.
Results: During the study period, 2504 corneas were retrieved from 1252 donors. The average
number of donors per year was 157 (Standard deviation: 20.01). There was a statistically
significant increase in the number of donors over the study period
(B-coefficient = 6.40, standard error=2, 07, p-value=0.02). Majority of donors were males
(68.6%). The mean age of donors was 40.4 years (Standard deviation: 15.97) and ranged from 3
months to 78 years. Whites were in overwhelming majority compared to other races, accounting
for 96% (number=1205), followed by Blacks 2% (number=24), Asians 1% (number=18) and
Coloureds <1% (number=5). The proportion of donated corneas used for transplantation (corneal
utilisation rate) averaged 87%. This rate showed a significant decline over the period studied (Bcoefficient=
-1.76, standard error=0.48, p-value=0.01). The commonest reason for discarding
corneas was damaged corneas (36%), followed by Human immunodeficiency virus infection
(18%) and inconclusive blood results (14%). The majority of donated corneas were used in
private practices (91%).
vi
The majority of donors were referred by mortuaries (50%) and private hospitals (37%). The
commonest indication for penetrating keratoplasty was keratoconus (46.8%), followed by
corneal scarring (27.8%) and pseudophakic bullous keratopathy (10.1%)
Conclusions: This analysis shows that the number of donors increased annually over the study
period. There were very few Blacks donating corneas in Johannesburg and most of the referrals
were from mortuaries and private hospitals. The distribution of corneal tissue in areas served by
the Gauteng cornea and eye bank is in favour of private hospitals. Corneal tissue damage and
HIV infection were the commonest reasons for discarding corneas. In private practices in
Johannesburg, keratoconus was the commonest indication for penetrating keratoplasty,
followed by traumatic corneal scarring.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/7999 |
| Date | 16 April 2010 |
| Creators | Makgotloe, Aubrey Zacharia |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf |
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