Corneal graft survival research and registry

The Australian Corneal Graft Registry (ACGR) operates an Australia-wide register of human corneal transplants. The purpose of the ACGR is to collect information to inform clinical practice and identify risk factors for poor patient outcomes. Started in May 1985, the ACGR currently contains over 46,000 records of corneal transplants.

Donor corneas are collected by Eye Banks who provide them to ophthalmic surgeons for transplantation. The ACGR has a standard registration form which is filled in by Eye Banks and surgeons to tell us about the surgery. The Eye Banks provide information about the donor, and how the donor cornea was collected and stored before the surgery. The surgeons provide information about the recipient of the transplant, and the type of operation performed.

The surgeons also regularly provide us with follow-up information. They tell us if the graft is surviving, what the patient’s vision is, and about any complications or additional treatments the patient has had since the graft. They do this for as long as possible - until the graft fails, the patient is known to have died, or they have not been seen for several years.

The team at the ACGR enter this data into a single database. They check to make sure that what has been reported makes sense, and then use specialist software to analyse the data. This identifies if there are certain factors that might be increasing the chance that a graft will fail or affecting the vision of the recipient. These factors could be related to the donor, the Eye Bank, the surgery, or the recipient. The results are then sent back to surgeons and Eye Banks, so that they can use the information to improve their practices, and the related outcomes for their patients.

The latest major report from the ACGR was released in 2022. The report included data on both full-thickness penetrating grafts and partial-thickness lamellar grafts. The census date for the grafts analysed was 31/03/2021. Data were analysed for almost 27,000 penetrating corneal grafts registered since 1985, plus 1,670 traditional lamellar grafts registered over the same period. Additionally, data on more than 10,000 endothelial grafts, registered since 2006, and over 2,000 deep anterior lamellar grafts, registered since 2000, were analysed.