SUPPLEMENTARY APPENDIX 2
The Registre des greffés cornéens du CHU de Québec-Université Laval is a regional registry launched in 2020. It covers all paediatric and adult corneal transplant procedures (namely PKP, ALK, DSEK and DMEK) performed in Quebec City (Canada). All cornea surgeons working in Quebec City’s metropolitan area participate in the registry. They collectively realize an average of 200 corneal transplants annually. The registry receives an indirect financial support from Héma-Québec, a public organization that supplies blood as well as cell and tissue products to hospitals of the Province of Quebec, in the form of an operating budget for the CHU de Québec-Université Laval’s eye bank.
Donor information is directly provided by Héma-Québec. Regarding recipient information, operative details and patient follow-up, data entry is performed in two steps. The cornea surgeons first record their clinical observations on standardised clinic forms during preoperative and postoperative visits. The eye bank specialists then access these clinic forms and enter pertinent data on the Microsoft Excel spreadsheet that constitutes the registry database. All eligible corneal graft procedures performed at the CHU de Québec- Université Laval are systematically registered in the database. Data entry is performed at the preoperative visit, on the day of surgery, on postoperative day 1, 6 months after the surgery, 12 months after the surgery and yearly thereafter. The graft is followed for 5 years, or until regraft or loss to follow-up occurs. Data elements gathered by the Registre des greffés cornéens du CHU de Québec-Université Laval are summarized in Table 3.
Table 3. List of the data elements collected by the Registre des greffés cornéens du CHU de Québec-Université Laval Donor and graft information
Donor demographic data (age at time of death, gender, ethnic origin) Diabetic donor (yes or no)
Donor cause of death
Date and time of donor death, enucleation, storage of corneal donor tissue, processing of corneal donor tissue and corneal graft surgery Type of corneal tissue product (full-thickness corneal tissue, precut corneal tissue, pre-peeled corneal tissue)
Graft endothelial cell count Precut graft pachymetry
Result of donor corneoscleral rim culture Recipient information
Recipient demographic data (date of birth, gender, ethnic origin)
Preoperative monocular best corrected Snellen visual acuity of both eyes and optical correction worn Recipient lens status prior to corneal transplantation procedure
Number of previous corneal grafts performed in each eye Previous ocular surgeries*
Ocular diseases limiting postoperative visual acuity† Risk factors for corneal graft failure‡
1 1
2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
1
Diabetic recipient (yes or no)
Time on surgical wait list (number of days between registration and corneal graft surgery) Operative details
Date of surgery Eye grafted (right or left)
Corneal transplant indication (diagnoses are categorized according to the EBAA classification system) Corneal grafting technique (PKP, ALK, DSEK, DMEK)
Graft and trephination opening size Accompanying surgical procedure(s)§ Intraoperative complications**
Cornea surgeon identity
Patient follow-up and postoperative outcome measures
Postoperative best corrected Snellen visual acuity of the grafted eye at each follow-up visit and optical correction worn Ocular diseases limiting postoperative visual acuity† (reassessed at each follow-up visit)
Graft rejection episodes (endothelial or non-endothelial) Graft failure (primary or secondary)
Other graft-related postoperative complications and adverse events††
Endothelial cell count of the grafted eye at each follow-up visit Anti-rejection medication (name)
Number of rebubbling procedures performed
Surgical procedures performed on the grafted eye since the corneal transplant*
* List of ocular surgeries recorded: Corneal refractive surgery, corneal cross-linking, superficial keratectomy with alcohol delamination of the corneal epithelium, iridoplasty or pupilloplasty, cataract surgery, glaucoma micro-invasive surgery, glaucoma drainage implant, trabeculectomy, scleral buckle, pars plana vitrectomy
† List of ocular diseases recorded: Amblyopia, visually significant cataract, retinal detachment, advanced glaucoma, non-glaucomatous optic neuropathy, vitreous hemorrhage, macular disease, uveitis, congenital ocular anomaly, unspecified ocular disease limiting postoperative visual acuity
‡ List of risk factors for corneal graft failure recorded: Previous graft failure, previous graft rejection episodes, active inflammation or infection, corneal surface disease, corneal perforation, superficial corneal vascularization (with number of quadrants), deep corneal vascularization (with number of quadrants)
§ List of accompanying surgical procedures recorded: Cataract extraction with intraocular lens implantation, intraocular lens exchange, implantation of scleral-fixated intraocular lens, anterior vitrectomy, superficial keratectomy, iridoplasty, synechialysis, retina surgery
** List of intraoperative complications recorded: Intraoperative floppy iris syndrome, excessive graft manipulation, vitreous in anterior chamber, blood or fibrin in anterior chamber, blood in graft-host interface, Descemet membrane perforation, positive posterior pressure, expulsive hemorrhage
†† List of postoperative complications recorded: Posterior lamellar graft detachment, pupillary bloc, ocular infection (including infectious keratitis and endophtalmitis), ocular surface disease