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Corneal graft survival

Replacement of diseased or injured corneal tissue, with that from a deceased donor, can restore sight and greatly improve quality of life for many individuals.

The Flinders University Department of Ophthalmology has lead the way in evaluation of this procedure in Australia, with the establishment of the Australian Corneal Graft Registry in 1985.

Laboratory based research also examines potential ways to extend the survival of these grafts.

Funding is provided by the Australian Organ and Tissue Donation Authority (DonateLife) for the operation of the ACGR, and through the Perpetual Trustee Company Ltd for project FR2013/1310: Improving the quality of human donor corneas for corneal transplantation.


Research focus areas

The Australian Corneal Graft Registry (ACGR)

The purpose of the Registry is to collect information that will inform clinical practice and to identify risk factors for poor patient outcomes. It currently contains records of over 33,000 corneal transplants, some of which have been followed for over 30 years.

Fast facts

  • All information is de-identified, to maintain confidentiality of the database
  • Information collected at the time of graft, and at points of follow-up, includes:
    • Demographic characteristics of the recipient and donor
    • The Eye Bank practices and the operative procedure
    • The graft and visual outcome
    • Relevant post-operative events and treatment
  • Major reports are open access.
  • Additional individual feedback is provided to contributing surgeons and Eye Banks.

Learn more


Improving the quality of human donor corneas for corneal transplantation

The two leading causes of corneal graft survival are allograft rejection and endothelial cell failure.

Animal models provide a means to better understand the causes of these complications and enable exploration of potential ways to prolong graft survival, through novel treatments.


Featured publications

  • Keane MC, Mills RA, Coster DJ, Williams KA; Contributors to the Australian Corneal Graft Registry. Clin Exp Ophthalmol. 2017 Aug;45(6):575-583. doi: 10.1111/ceo.12921. Epub 2017 Feb 27
  • Keane MC, Galettis RA, Mills RA, Coster DJ, Williams KA; for Contributors to the Australian Corneal Graft Registry. A comparison of endothelial and penetrating keratoplasty outcomes following failed penetrating keratoplasty: a registry study. Br J Ophthalmol. 2016 Nov; 100(11):1569-1575. doi: 10.1136/bjophthalmol-2015-307792. Epub 2016 Feb 18.
  • Coster DJ, Lowe MT, Keane MC, Williams KA; Australian Corneal Graft Registry Contributors. A comparison of lamellar and penetrating keratoplasty outcomes: a registry study. Ophthalmology. 2014 May; 121(5):979-87. doi: 10.1016/j.ophtha.2013.12.017. Epub 2014 Feb 1.


  • Mills RA, Klebe S, Coster DJ, Williams KA. Comparative outcomes of penetrating and component endothelial cell corneal allografts in outbred sheep. Cell Transplant. 2014 Jan; 23(1):133-8. doi: 10.3727/096368912X659835. Epub 2012 Dec 4.
  • Appleby SL, Jessup CF, Mortimer LA, Kirk K, Brereton HM, Coster DJ, Tan CK, Williams KA. Expression of an anti-CD4 single-chain antibody fragment from the donor cornea can prolong corneal allograft survival in inbred rats. Br J Ophthalmol. 2013 Jan; 97(1):101-5. doi: 10.1136/bjophthalmol-2012-302360. Epub 2012 Nov 21.
  • Brice SL, Kirk K, Brereton HM, Coster DJ, Williams KA. The influence of cervical and thoracic lymphadenectomy on corneal allograft rejection in inbred rats. Br J Ophthalmol. 2012 Mar; 96(3):448-50. doi: 10.1136/bjophthalmol-2011-300934. Epub 2011 Nov 23.