Corneal Disease Profile and Transplant Eligibility at a Tertiary Hospital in Dar es Salaam, Tanzania

Abstract

Purpose:                                                                                                                                                                                                                        To determine the profile of corneal diseases and assess eligibility for corneal transplantation among patients attending the Eye Department at Muhimbili National Hospital (MNH), Tanzania.

Methods: We conducted a hospital-based descriptive cross-sectional study from July to December 2021, consecutively enrolling all patients with corneal diseases attended the eye department during the study period. Data were collected via interviewer-administered questionnaire. Ocular examinations (including B-scan when indicated) were performed. Transplant eligibility was assessed based on BCVA and lesion characteristics. Data were analyzed using SPSS version 23, and chi-square tests assessed associations between transplant eligibility and sociodemographic characteristics.

Results: A total of 243 participants, contributing 268 affected eyes were recruited and analyzed. Half (50.6%) were aged between 0-20 years. The median age was 20 years (IQR 8–46), and 56% were male. Traumatic corneal injuries (32.5%) and infectious keratitis (29.9%) were the most common diagnoses. Among affected eyes, 52 (19.4%) met criteria for corneal transplantation. The leading indications were advanced infectious keratitis (44.2%) and traumatic perforations (23.1%). Most eligible eyes (71.2%) had severe visual impairment. Optical keratoplasty was indicated in 57.7% and therapeutic in 21% of eyes. Higher education level was significantly associated with transplant eligibility (p = 0.037)

Conclusions: About one in every five patients with corneal disease required corneal transplantation, mostly young individuals with severe visual impairment, primarily due to trauma and advanced infectious keratitis. These findings underscore the urgent need to establish corneal transplant services, promote development of policies to support corneal and eye donation, establish a functional eye bank, and implement preventive strategies against ocular trauma and infection