Current state of mechanical corneal surgery - Results of a questionnaire to members of the cornea section of the German Society of Ophthalmologists

Aim: The aim of this study was to obtain an overview on the surgical and the perioperative management strategies involved in mechanical corneal surgery in Germany, Switzerland and Austria. Method: A questionnaire was sent to 60 ophthalmological hospitals. Results: Within one year the responding centres (n = 48) performed 3171 penetrating and 166 lamellar keratoplasties, 224 limbal stem cell- and 817 amniotic-membrane transplantations. In high-risk cases, 33% of the centres did not use HLA-matched grafts. Predominantly manual trephine systems were used. Of the responding institutions 96% used 10.0 nylon sutures and 64% used a double running anti-torque technique for normal-risk keratoplasty. In tectonic and high-risk keratoplasties, interrupted sutures were used predominantly (70% and 56%). Suture removal was performed between one month (first suture) and up to 36 months (last suture) post-operatively. Conclusions: Procedures considered to be standard - such as penetrating keratoplasty - are performed with numerous and significant technical variations. The likely influence of such variations on the long-term outcome should be further evaluated.