1. Table 2.1.1: New Transplant Rate per million population (pmp), 1998-2005 Year19981999200020012002200320042005 New transplants 119122126221203165184192 New transplant rate pmp 55598777 Figure 2.1.1: New transplant rate, 1998-2005 New transplant rate, pmp Year 0 1 2 3 4 5 6 7 8 9 Rate, pmp 1998 1999 2000 2001 2002 2003 2004 2005

2. Table 2.1.2: Types of Cornea Transplant, 1998-2005 Year1998 (N = 119) 1999 (N = 122) 2000 (N = 126) 2001 (N = 221) 2002 (N = 203) No.% % % % % Penetrating Keratoplasty1149611695120952079419697 Lamellar Keratoplasty11545414652 Patch Graft for Cornea0000000000 Patch Graft for Sclera 0000000000 Cornea Scleral Keratoplasty 0011000000 No data 4300110021 Year2003 (N = 165) 2004 (N = 184) 2005 (N = 192) TOTAL (N = 1332) No.% % % % Penetrating Keratoplasty 156951659017390124794 Lamellar Keratoplasty 85105137615 Patch Graft for Cornea 00213250 Patch Graft for Sclera 00001010 Cornea Scleral Keratoplasty 107421111 No data 00000070

3. Table 2.2.1: Gender distribution, 1998-2005 Year1998 (N = 119) 1999 (N = 122) 2000 (N = 126) 2001 (N = 221) 2002 (N = 203) GenderNo.% % % % % Male 7866806681641436512260 Female 41344234453678358140 No data 0 000000000 Year2003 (N = 165) 2004 (N = 184) 2005 (N = 192) TOTAL (N = 1332) GenderNo.% % % % Male 11469112611145984463 Female 51317239774048737 No data00001110

4. Table 2.2.2: Ethnic distribution, 1998-2005 Year1998 (N = 119) 1999 (N = 122) 2000 (N = 126) 2001 (N = 221) 2002 (N = 203) Ethnic groupNo.% % % % % Malay 28243428413370327436 Chinese 47394638504092428341 Indian 36303529282249223517 Bumiputra Sabah 0000000000 Bumiputra Sarawak 0000001000 Others 8775655295 No data 0000104221 Year2003 (N = 165) 2004 (N = 184) 2005 (N = 192) TOTAL (N = 1332) Ethnic groupNo.% % % % Malay 52326636623242732 Chinese 67415832733851639 Indian 34204323412130122 Bumiputra Sabah 00111120 Bumiputra Sarawak 004253101 Others 117105 5665 No data 102100101 *Others: Non Malaysian

5. Figure 2.2.1: Ethnic distribution, 1998-2005 Percent Ethnic group 0 5 10 15 20 25 30 35 40 45 Malay Chinese Indian Bumiputra Sabah Bumiputra Sarawak Others 1998 1999 2000 2001 2002 2003 2004 2005

6. Table 2.2.3: Age distribution of cornea transplant recipient patients, 1998-2005 Year1998 (N = 119) 1999 (N = 122) 2000 (N = 126) 2001 (N = 221) 2002 (N = 203) Age group (years)No.% % % % % 0-9 4354658494 10-19 13111714972913168 20-39 28243428342749225326 40-59 3832 26403261285728 >=60 36303428372974336834 Mean 4543444546 SD 21222021 Median 4543455046 Minimum 4 months52 months5 months1 Maximum 8292868586 Year2003 (N = 165) 2004 (N = 184) 2005 (N = 192) TOTAL (N = 1332) Age group (years)No.% % % % 0-9636484524 10-19211315814713410 20-3936225530593134826 40-5951315228452437628 >=6051315630663442232 Mean45 4645 SD21 Median46444946 Minimum5 months2 months Maximum84868492 Age=date transplant-date birth; age if provided

7. Figure 2.2.2: Age distribution of cornea transplant recipient patients, 1998-2005 Percent Year 0 5 10 15 20 25 30 35 0-9 years 10-19 years 20-39 years 40-59 years >=60 years 1998 1999 2000 2001 2002 2003 2004 2005

8. Table 2.2.4: Primary diagnosis, 1998-2005 Year1998 (N=119) 1999 (N=122) 2000 (N=126) 2001 (N=221) 2002 (N=203) Primary DiagnosisNo.% % % % % Corneal scar33282520211734152814 Keratoconus24202420151238173216 Microbial keratitis119 9191530143115 Other (non pseudophakic) bullous keratopathy141243191537174723 Corneal perforation (non microbial)657686125 6 Pseudophakic bullous keratopathy108161317132310157 Failed previous graft1412 101310178157 Corneal dystrophy54655412594 Congenital opacity1111111000 Microbial keratitis + Corneal perforation1165116342 Others338776157147 No data 0022111000

9. Table 2.2.4: Primary diagnosis, 1998-2005 Year2003 (N=165) 2004 (N=184) 2005 (N=192) TOTAL (N=1332*) Primary DiagnosisNo.% % % % Corneal scar21132514201020716 Keratoconus18113418341821916 Microbial keratitis2113181013715412 Other (non pseudophakic) bullous keratopathy251516914717613 Corneal perforation (non microbial)27161371891038 Pseudophakic bullous keratopathy19121910351815412 Failed previous graft1481271471118 Corneal dystrophy748463584 Congenital opacity118432161 Microbial keratitis + Corneal perforation421792010594 Others106341835181269 No data 00110050 *1219 patients have 1 primary diagnosis, 104 have 2 primary diagnoses, 4 patients had 3 diagnoses, and 1 patient had 4 diagnoses

10. Figure 2.2.3: Primary Diagnosis in Recipients, 1998-2005 CS= Corneal Scar KC= Keratoconus MK = Microbial keratitis PBK= Pseudophakic bullous keratopathy

11. Table 2.2.5: Indications of cornea transplant, 2004-2005 Indication of transplant2004 (N = 184) 2005 (N = 192) Total (N = 376) No.% % % Optical 119651316825066 Tectonic 261423114913 Therapeutic 291622115114 Tectonic + Therapeutic 9595185 Optical + Tectonic 101121 Optical + Tectonic + Therapeutic 001110 Others 004241 No data 001110

12. Table 2.3.1.1: Number of cornea transplants with complete data set 20042005Total No.% % % Total no. of cornea transplants performed184100192100376100 No. of cornea transplants with notification complete data set138751588229679

13. Table 2.3.2.1: No of previous grafts in grafted eye, 2004-2005 Graft Number2004 (N=138) 2005 (N=158) Total (N = 296) No.% % % 0 123891439026690 1 118128238 2 322152 3 001110 4 110010

14. Table 2.3.2.2: Ocular co-morbidity, 2004-2005 2004 (N=138) 2005 (N=158) Total (N = 296) Ocular co-morbidityNo.% % % Any ocular co-morbidity (a to c below) 88641026519064 a) Cornea vascularisation 7756784915582 Superficial vascularisation 443248309248 Deep vascularisation 423038248042 b) History of glaucoma 292136236534 c) Current ocular inflammation 413049319047 *Patient might have multiple ocular co-morbidity

15. Table 2.3.2.3: Pre-operative vision, 2004-2005 2004 (N=138) 2005 (N=158) Total (N = 296) Unaided VANo.% % % 6/6 320031 6/9 111121 6/12 002121 6/18 001110 6/24 325383 6/36 4364103 6/60 751610238 5/60 110010 4/60 321141 3/60 212141 2/60 112131 1/60 4396134 CF 473447299433 HM 473446299332 PL 1310159289 NPL 211131 No data 004341

16. Table 2.3.3.1: Source of Donor Cornea Tissue, 2004-2005 2004 (N=138) 2005 (N=158) Total (N = 296) Source of donorNo.% % % Local 201419123913 USA 95691127120770 Sri Lanka 221627174917 No data 110010 If Local, ethnic group:  Malay 00421410  Chinese 14708422256  Indian 5256321128  No data 151526

17. Figure 2.3.3.1: Source of Donor Corneal Tissue, 2004-2005 Percent Year 0 10 20 30 40 50 60 70 Local USA Sri Lanka 20042005

18. Table 2.3.3.2: Donor age distribution, 2004-2005 2004 (N=138) 2005 (N=158) Total (N = 296) Age, yearsNo.% % % 0-9 213252 10-19 6443103 20-39 11874186 40-59 5238774912944 >=60 6749674213445 Mean 5657 SD1514 15 Median 5957 58 Minimum 83 3 Maximum 7879

19. Figure 2.3.3.2: Donor age distribution, 2004-2005 0.05.1.15.2.25.3 Fraction 5101520253035404550556065707580 Age of Donor (years)

20. Table 2.3.3.3: Preservation media, 2004-2005 2004 (N=138) 2005 (N=158) Total (N = 296) Preservation mediaNo.% % % Optisol GS 110801278023780 MK Medium 221625164716 Moist Chamber 433272 No data 213252 Figure 2.3.3.3: Preservation media, 2004-2005 Percent Year 0 10 20 30 40 50 60 70 80 Optisol MK Medium Moist Chamber 20042005

21. Table 2.3.3.4: Cause of death in cornea donors, 2004-2005 2004 (N=138) 2005 (N=158) Total (N = 296) Cause of death No.% % % Cardiac / Circulatory System473537238428 Cerebrovascular System171223154014 Malignancy191426164515 Trauma / Accident20141063010 Respiratory System151185238 Others17121383010 No data3241274415

22. Table 2.3.4.1: Type of surgery, 2004-2005 2004 (N=138) 2005 (N=158) Total (N = 296) Type of surgeryNo.% % % Penetrating Keratoplasty 120881398825988 Lamellar Keratoplasty 107138237 Patch Graft for Cornea 213252 Patch Graft for Sclera 001110 Cornea Scleral Keratopalsty 642183

23. Table 2.3.4.2: Type of Combined surgery, 2004-2005 2004 (N=138)* 2005 (N=158)** Total (N = 296) Combined surgeryNo.% % % No. of patients with combined surgery312226165719 (a) Glaucoma surgery213259 (b) Cataract Extraction16121382951 (c ) IOL1410962340 (d) Retinal Surgery + Internal Tamponade111124 (e) Anterior vitrectomy97321221 (f) Others54851323 *14 patients had 2 types of surgeries and 1 patient had 3 types of surgeries, combined with the corneal transplant surgery **11 patients had 2 types of surgeries combined with the corneal transplant surgery.

24. Table 2.3.4.3: Recipient Cornea Trephined Size, 2004-2005 2004 (N=138) 2005 (N=158) Total (N = 296) Graft size, mmNo.% % % 2 111121 3 001110 4 112131 5 000000 5.5 110010 6 320031 6.25 001110 6.50 215372 6.75 113241 7 251836236122 7.25 107 6207 7.50 362618115418 7.75 107117217 8 191474269 8.25 434383 8.50 6464124 8.75 001110 9 8632114 9.25 000000 9.50 002121 9.75 000000 10 110010 No data 10747295719 Mean 7.57.37.4 SD 111 Median 7.57.257.5 Minimum 222 Maximum 109.510

25. Table 2.3.4.4: Difference in trephined sizes of recipient and donor corneas, 2004-2005 2004 (N=138) 2005 (N=158) Total (N = 296) Difference in Graft size, mmNo.% % % Same size 9785176 0.25 292119124816 0.5 8762845317159 0.75 110010 1 110010 2 110010 No data 10747305719

26. Table 2.3.4.5: Suture Technique, 2004-2005 2004 (N=138) 2005 (N=158) Total (N = 296) Suture Technique No.% % % Interrupted only132961388827092 Continuous only000000 Combined641812248

27. Table 2.4.1.1: Stock and flow Year2004 No.% New transplant184100 On follow up15082 Lost to follow up3418 Dead00 Table 2.4.2.1: Post transplant graft status (Optical and Non-Optical) 2004 (N = 150) No.% Graft survival 12080 Graft failure 3020 Table 2.4.2.2: Post Transplant graft Status by Optical and Non-Optical Indication 2004 (N = 150) Optical (N = 99)Non-Optical (N = 51) No.% % Graft survival 91922957 Graft failure 882243 * Subjects with both optical & non-optical indications were classified into the optical group

28. Table 2.4.2.3: Causes of graft failure 2004 No.% Graft Failure 3020 Cause of Failure Primary graft failure or Primary Endothelial decompensation 413 Recurrence of primary disease 413 Late Endothelial decompensation 827 Glaucoma 517 Infection 413 Graft rejection 620 Others 723 No data 310 *Each patient may have more than one cause of graft failure * Data represents causes from surgeons who provided a complete data set

29. Table 2.4.3.1: Available data on post corneal transplant vision Unaided Vision (N = 150)Best Corrected Visual Acuity (N = 150) No.% % Data available 137914530 No data 13910570 Table 2.4.3.2: Post transplant Unaided Vision (Optical and Non-Optical) 2004 (N = 137) Post transplant Unaided Vision No.% 6/6 32 6/9 54 6/12 54 6/18 118 6/24 2015 6/36 1813 6/60 2418 5/60 00 4/60 00 3/60 32 2/60 10 1/60 10 CF 1612 HM 1914 PL 64 NPL 54

30. Figure 2.4.3.1: Post transplant Unaided Vision Percent Unaided Vision 0 2 4 6 8 10 12 14 16 18 20 percent 6/6 6/9 6/12 6/18 6/24 6/36 6/60 5/60 4/60 3/60 2/60 1/60 CF HM PL NPL

31. Table 2.4.3.3: Post transplant Best Corrected Visual Acuity (Optical and Non-Optical) 2004 (N = 45) Post transplant best corrected Visual Acuity No.% 6/6 49 6/9 716 6/12 1329 6/18 613 6/24 511 6/36 37 6/60 37 5/60 00 4/60 00 3/60 00 2/60 00 1/60 12 CF 24 HM 12 PL 00 NPL 00

32. Figure 2.4.3.2: Post transplant Best Corrected Visual Acuity Percent Best Corrected Visual Acuity 0 5 10 15 20 25 30 percent 6/6 6/9 6/12 6/18 6/24 6/36 6/60 5/60 4/60 3/60 2/60 1/60 CF HM PL NPL

33. Table 2.4.3.4: Post transplant Unaided Vision by Optical and Non-Optical indication 2004 (N = 137) Optical (N = 94)Non-Optical (N = 43) Post Transplant Unaided Vision No.% % 6/6 00 37 6/9 22 37 6/12 44 00 6/18 910 25 6/24 1820 25 6/36 1618 12 6/60 1921 49 5/60 00 00 4/60 00 00 3/60 22 12 2/60 00 12 1/60 11 00 CF 1011 614 HM 78 1228 PL 11 512 NPL 22 37 * Missing unaided vision excluded

34. Figure 2.4.3.3a: Post transplant Unaided Vision by Optical indication Percent Unaided Vision 0 2 4 6 8 10 12 14 16 18 20 22 percent 6/6 6/9 6/12 6/18 6/24 6/36 6/60 5/60 4/60 3/60 2/60 1/60 CF HM PL NPL

35. Figure 2.4.3.3b: Post transplant Unaided Vision by Non-Optical indication Percent Unaided Vision 0 5 10 15 20 25 30 percent 6/6 6/9 6/12 6/18 6/24 6/36 6/60 5/60 4/60 3/60 2/60 1/60 CF HM PL NPL

36. Table 2.4.3.5: Factors for Post-op Best Corrected Visual Acuity of worse than 6/12 2004 No.% Post BCVA worse than 6/122147 Factors High astigmatism420 Glaucoma15 Retinal Detachment00 Cataract420 Cornea Decompensation210 DM Retinopathy00 Others525 No data735 *Patient with BCVA worse than 6/12 might have more than one factor

37. Table 2.5.1: Stock and Flow 2004 No.% Total no. of cornea transplants performed184100 No. of cornea transplants on follow-up15082 No. of outcome with complete data set7943 Table 2.5.2: Post transplant complications 2004 No.% Any complications4759 Complications Epithelial Problem715 Wound Dehiscence12 Suture infiltration / abscess49 Endophthalmitis00 Microbial keratitis613 Vascularisation511 Post-keratoplasty glaucoma1328 Graft Rejection817 No data1838 * Each patient may have more than one complication

38. Table 2.5.3: Post transplant graft rejection types 2004 No.% Graft Rejection810 TypesEpithelial225 Stromal113 Endothelial563 No data113 * Each patient may have more than one type of rejection