{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T20:05:44Z","timestamp":1787947544423,"version":"build-2784847793"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,4,7]],"date-time":"2016-04-07T00:00:00Z","timestamp":1459987200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Dr. F.P. Fischer Foundation"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Keratoconus is a progressive disorder and one of the primary indications for corneal transplantation. Anterior lamellar keratoplasty offers several advantages over other techniques, including endothelial preservation and longer graft survival. In this study, we examined the recent trend of using lamellar techniques for keratoconus at a national level.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were obtained from the Dutch national organ transplant database regarding corneal transplants for keratoconus performed in 2005 through 2014. Baseline characteristics for patients undergoing various techniques were obtained, and temporal trends were analysed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1041 operations were performed, including 736 penetrating keratoplasties (<jats:styled-content style=\"fixed-case\">PKP<\/jats:styled-content>s) and 297 anterior lamellar keratoplasties (<jats:styled-content style=\"fixed-case\">ALK<\/jats:styled-content>s). The mean age of the total surgical group was 37.4\u00a0\u00b1\u00a013.4\u00a0years, and 68% of patients were male (p<jats:italic>\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.0001). Preoperative patient characteristics were reported in all 1041 cases. The relative proportion of <jats:styled-content style=\"fixed-case\">ALK<\/jats:styled-content>s increased from 2005 (19% of cases) to 2010 (39% of cases) and remained approximately 30\u201340% thereafter. Descemet baring or deep anterior lamellar keratoplasty (<jats:styled-content style=\"fixed-case\">DALK<\/jats:styled-content>) was increasingly applied and was the predominant anterior lamellar technique performed from 2009 onwards.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The number of corneal transplantations performed annually for keratoconus decreased during the past 10\u00a0years. Lamellar techniques were increasingly performed, accounting for approximately 35% of keratoplasties in 2010 and thereafter. Among <jats:styled-content style=\"fixed-case\">ALK<\/jats:styled-content> techniques, maximal depth <jats:styled-content style=\"fixed-case\">DALK<\/jats:styled-content> is the most prevalent keratoplasty performed for keratoconus in most recent years. Penetrating keratoplasty (PKP) is still common, with a stable frequency from 2010 onwards.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aos.13041","type":"journal-article","created":{"date-parts":[[2016,4,10]],"date-time":"2016-04-10T17:41:39Z","timestamp":1460310099000},"page":"489-493","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Trends in penetrating and anterior lamellar corneal grafting techniques for keratoconus: a national registry study"],"prefix":"10.1111","volume":"94","author":[{"given":"Daniel A.","family":"Godefrooij","sequence":"first","affiliation":[{"name":"Utrecht Cornea Research Group Department of Ophthalmology University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renze","family":"Gans","sequence":"additional","affiliation":[{"name":"Utrecht Cornea Research Group Department of Ophthalmology University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saskia M.","family":"Imhof","sequence":"additional","affiliation":[{"name":"Utrecht Cornea Research Group Department of Ophthalmology University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert P.L.","family":"Wisse","sequence":"additional","affiliation":[{"name":"Utrecht Cornea Research Group Department of Ophthalmology University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,4,7]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(99)00002-0"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2011.07.057"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2010.06.005"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2013.12.017"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ico.0000214211.60317.1f"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2014.10.040"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.eye.6701903"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2009.05.028"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrs.2014.08.043"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2014.08.029"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/archophthalmol.2011.2585"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/archophthalmol.2011.7"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9394(86)90817-2"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10384-010-0914-x"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/aos.12705"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrs.2007.02.016"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/aos.12811"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.83.3.327"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2012.08.001"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6257(97)00119-7"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clae.2010.04.006"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0000000000000460"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.icu.0000233953.09595.91"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003226-199905000-00001"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0b013e31812f685c"},{"key":"e_1_2_5_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0000000000000066"},{"key":"e_1_2_5_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/aos.12281"},{"key":"e_1_2_5_29_1","doi-asserted-by":"publisher","DOI":"10.4103\/0974-9233.97941"},{"key":"e_1_2_5_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcjo.2012.12.008"}],"container-title":["Acta Ophthalmologica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Faos.13041","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aos.13041","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T12:59:10Z","timestamp":1695473950000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aos.13041"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,4,7]]},"references-count":29,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2016,8]]}},"alternative-id":["10.1111\/aos.13041"],"URL":"https:\/\/doi.org\/10.1111\/aos.13041","archive":["Portico"],"relation":{},"ISSN":["1755-375X","1755-3768"],"issn-type":[{"value":"1755-375X","type":"print"},{"value":"1755-3768","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,4,7]]},"assertion":[{"value":"2015-09-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-02-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-04-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}