A Comprehensive Analysis of 6-Year Keratoplasty Trends at a Tertiary Eye Hospital in Jakarta, Indonesia

Purpose: To present demographic data on corneal diseases leading to keratoplasty, trends of keratoplasty, corneal procurement, and graft survival in Indonesia. Methods: A retrospective cohort study of patients who underwent keratoplasty, including deep anterior lamellar keratoplasty (DALK), endothelial keratoplasty (EK), and penetrating keratoplasty (PKP) from January 2018 to November 2024 was conducted. Details on donor and patient demographic data were collected from medical records. The cumulative probability of graft survival rates was analyzed using the Kaplan–Meier curve. Results: A total of 489 keratoplasty procedures were performed during the study period. EK (261, 53.4%) represented the most common procedures, followed by PKP (215, 44.0%) and DALK (13, 2.6%). Imported (368, 75.3%) corneal donors dominated the corneal procurement. Bullous keratopathy (BK, 234, 47.9%) was the common diagnosis for keratoplasty, followed by corneal scars postinfection (99, 20.2%) and repeat keratoplasty after graft failure (77, 15.7%) in overall cohorts. EK remained the first treatment choice for BK (199, 40.7%), whereas PKP was for corneal scars postinfection (92, 18.8%) and repeat keratoplasty because of graft failure (44, 9.0%). The cumulative graft survival rates of EK (90.9%) were superior to PKP (90.6%) and DALK (88.9%) on third postoperative visit. Conclusions: BK is the leading cause of indication for keratoplasty, and EK is the most common procedure. Most corneal donors are from imported sources, and local corneal donors only provide one-third. EK shows better graft survival rates than other keratoplasties.