1. Table 2.1.1: Number of Corneal Transplantation and Transplant Rate per million population (pmp), 1998-2007 Year1998199920002001200220032004200520062007 No. of new transplants 119122126221203165184192177 189 New transplant rate pmp 555987777 7 Table 2.1.2: Types of Corneal Transplant, 1998-2007 Year1998 (N=119) 1999 (N=122) 2000 (N=126) 2001 (N=221) 2002 (N=203) No.% % % % % Penetrating Keratoplasty1149611695120952079419697 Lamellar Keratoplasty11545414652 Patch Graft for Corneal0000000000 Patch Graft for Sclera 0000000000 Cornea Scleral Keratopalsty0011000000 No data4300110021 Year2003 (N=165)2004 (N=184)2005 (N=192)2006 (N=177)2007 (N=189)TOTAL (N=1698) No.% % % % % % Penetrating Keratoplasty1569516590173901538616888156892 Lamellar Keratoplasty8510513716953825 Patch Graft for Corneal00213253105201 Patch Graft for Sclera 000010113250 Cornea Scleral Keratopalsty1074212132161 No data000000000071

2. Table 2.2.1: Gender distribution, 1998-2007 Year1998 (N=119) 1999 (N=122) 2000 (N=126) 2001 (N=221) 2002 (N=203) 2003 (N=165) 2004 (N=184) 2005 (N=192) 2006 (N=177) 2007 (N=189) TOTAL (N=1698) GenderNo.% % % % % % % % % % % Male 78668066816414264122601146911261115601186712466108664 Female 413442344536793681405131723977405933653461236 Table 2.2.2: Ethnic distribution, 1998-2007 Year1998 (N=119) 1999 (N=122) 2000 (N=126) 2001 (N=221) 2002 (N=203) 2003 (N=165) 2004 (N=184) 2005 (N=192) 2006 (N=177) 2007 (N=189) TOTAL (N=1698) Ethnic group No.% % % % % % % % % % % Malay 282434284133703274365232663662326034623354932 Chinese 473946385040924283416741583273385933653564138 Indian 363035292822492235173420432341214023381937822 Bumiputra Sabah0000000000001111322170 Bumiputra Sarawak00000010000042534242181 Others 8775655295117105 51161810956 No Data00001042211021000000101

3. Table 2.2.3: Age distribution of corneal transplant recipient patients, 1998-2007 Year1998 (N=119) 1999 (N=122) 2000 (N=126) 2001 (N=221) 2002 (N=203) 2003 (N=165) 2004 (N=184) 2005 (N=192) 2006 (N=177) 2007 (N=189) TOTAL (N=1698) Age group (years) No.% % % % % % % % % % % 0-9 43546584946463847442634 10-19 1311171497291316821131581472313 717010 20-39 282434283427492253263622553059315330482644926 40-59 3832 264032612857285131522845234123633348028 >=60 363034283729743368335131563066345330613253632 Mean 454344454645 4644 4745 SD 21222021 22 21 Median 4543455046 444943 4946 Minimum 4 months52 months5 months1 2 months 3 Maximum 829286858684868496 102

4. Table 2.2.4: Primary diagnosis, 1998-2007 Year 1998 (N=119) 1999 (N=122) 2000 (N=126) 2001 (N=221) 2002 (N=203) 2003 (N=165) 2004 (N=184) 2005 (N=192) 2006 (N=177) 2007 (N=189) TOTAL (N=1698) Primary Diagnosis No.% % % % % % % % % % % Keratoconus242024201512381732161811341834183319 291528117 Corneal scar332825202117341528142113261420101810 251325115 Microbial keratitis 119 919153014311521131810137116 13717810 Microbial keratitis+Corne a perforation 116511634242179201074 5764 Corneal perforation (non microbial) 657686125 627161371892011 21111448 Pseudophakic Bullous keratopathy 1081613171323101571912191035183017 321721613 Other (non psedophakic) bullous keratopathy 1412431915371747232515169147116 8419511 Failed previous graft 1412 101310178157148127147106 23121448 Corneal dystrophy 54655412594748463106 137815 Congenital opacity 111111100011844211 11191 Others 338776157147106341834183620 382019912 No data 002211100000000000 1150 *1650 patients have 1 primary diagnosis, 168 have 2 primary diagnoses, 11 patients had 3 diagnoses, and 1 patient had 4 diagnoses

5. Table 2.2.5: Indications of Corneal Transplant, 2004-2007 Indication of transplant2004 (N=184) 2005 (N=192) 2006 (N=177) 2007 (N=189) TOTAL (N=742) %No.% % % % Optical 1206513570124701326951169 Tectonic 2614231220111798612 Therapeutic 2714191017924138712 Tectonic + Therapeutic95954284304 Optical + Tectonic1111110030 Optical + Tectonic + Therapeutic0011001120 Optical + Therapeutic00005363112 Optical + Others0000110010 Others11424211101 No data0000110010 Table 2.3.1.1: No of Previous Grafts in Grafted Eye, 2004-2007 Graft Number2004 * (N=138) 2005 (N=192) 2006 (N=177) 2007 (N=189) Total (N=696) No.% % % % % 0 123891718916090156 83 61088 1 118158 828 15 6910 2 3221114 2 1 3 0042110 0 51 4 1100001 0 20 * In the year 2004 there were a total of 184 corneal transplants performed but complete data set was only received for 138 patients.

6. Table 2.3.1.2: Ocular Co-morbidity, 2004-2007 2004 (N=138) 2005 (N=192) 2006 (N=177) 2007 (N=189) Total (N=696) Ocular co-morbidityNo.% % % % % Any ocular co-morbidity (a to d below) 8864103548146834435551 a) Superficial corneal vascularisation 445748614373497418465 b) Deep corneal vascularisation 425539492237263912946 c) History of glaucoma 29333635 43364313638 d) Current ocular inflammation 414750494151394717148 *Patient might have multiple ocular co-morbidities. Table 2.3.1.3: Pre-operative Vision, 2004-2007

7. Table 2.3.2.1: Source of Donor Cornea Tissue, 2004-2007 2004* (N=138) 2005 (N=192) 2006 (N=177) 2007 (N=189) Total (N=696) Source of donorNo.% % % % % Local 2014 19103620 311610615 USA 9569 133699856 1075743362 Sri Lanka 2216 38204123 512715222 Others 00 0021 0020 No data 11 2100 0031 If Local, ethnic group: Malay 00 42113 516109 Chinese 1470 8421233 18585249 Indian 525 7372364 4133937 Others 00 0000 41344 No data 15 0000 0011 * In the year 2004 there were a total of 184 corneal transplants performed but complete data set was only received for 138 patients. Figure 2.3.2.1: Source of Donor Corneal Tissue, 2004-2007

8. Table 2.3.2.2: Donor Age Distribution, 2004-2007 2004 (N=138) 2005 (N=192) 2006 (N=174) 2007 (N=189) Total (N=696) Age, yearsNo.% % % % 0-9 2132212191 10-19 64429553244 20-39 11874 6137426 40-59 523889468146794130143 ≥60 674989467442904832046 Mean 56585657 SD1514161415 Median 5958565958 Minimum 83643 Maximum 787978 79 Table 2.3.2.3: Preservation Media, 2004-2007 2004 (N=138) 2005 (N=192) 2006 (N=177) 2007 (N=189) Total (N=696) Preservation mediaNo.% % % % % Optisol GS1108014777129731276751374 MK Medium221637194023512715021 Moist Chamber43327484223 Others*001*0003241 No data2142100071 *Others : Eusol-C

9. Figure 2.3.2.3: Preservation Media, 2004-2007 Table 2.3.2.4: Cause of Death in Corneal Donors, 2004-2007 2004 (N=138) 2005 (N=192) 2006 (N=177) 2007 (N=189) Total (N=696) Cause of death No.% % % % % Cardiac / Circulatory System473449265933743922933 Cerebrovascular System1712251311623127611 Malignancy19143116251423129814 Trauma / Accident2014137191124137611 Respiratory System15118485137446 Others17122111271531169614 No data3245232816117711

10. Table 2.3.3.1: Types of Surgeries, 2004-2007 2004 (N=138) 2005 (N=192) 2006 (N=177) 2007 (N=189) Total (N=696) Type of surgeryNo.% % % % % Penetrating Keratoplasty1208817390153861688961488 Lamellar Keratoplasty10713716952446 Patch graft for corneal 213253105203 Patch graft for scleral 0010113251 Cornea Scleral Lamellar Keratoplasty 64212132132 * In the year 2004 there were a total of 184 corneal transplants performed but complete data set was only received for 138 patients. 2004 (N=138) 2005 (N=192) 2006 (N=177) 2007 (N=189) Total (N=696) Combined surgeries No.% % % % % No. of patients with corneal transplant surgery combined with another surgical procedure312227144224331713319 (a) Glaucoma surgery26311250075 (b) Cataract Extraction16521348225213396448 (c ) IOL14451037245717526549 (d) Cataract extraction and IOL1032830163810304433 (e) Retinal Surgery + Internal Tamponade13142541286 (f) Anterior vitrectomy92931151210302720 (g) Others51683081916483728 *Patients may have more than one combined surgery. Table 2.3.3.2: Types of Combined Surgeries, 2004-2007

11. 2004 (N=138) 2005 (N=192) 2006 (N=177) 2007 (N=189) Total (N=696) Graft size, mmNo.% % % % % 2 1111211151 3 0011211141 4 1121115391 5 0000001110 5.5 1100000010 6 32005342122 6.25 0011000010 6.50 21524284193 6.75 1132211171 7 251836182514281511416 7.25 107 514853396 7.50 36261892615351811517 7.75 10711563105375 8 191474137179568 8.25 43425342172 8.50 646321115254 8.75 0011000010 9 86321142162 9.25 0000000000 9.50 0021000020 9.75 0000000000 10 1100000010 No data 10781426939542821431 Mean 7.57.37.27.3 SD 0.911.1 1 Median 7.57.3 7.5 Minimum 22222 Maximum 109.59910 Table 2.3.3.3: Recipient Cornea Trephine Size, 2005-2007

12. Table 2.3.3.4: Difference in Trephined Sizes of Recipient and Donor Corneas, 2004-2007 2004 (N=138) 2005 (N=192) 2006 (N=177) 2007 (N=189) Total (N=696) Difference in Graft size, mmNo.% % % % % Same size 978485126375 0.25 292119103017251310315 0.5 876384446738904832847 0.75 1100101131 1 1100104261 2 1100000010 Not available 10781427040573021831 Table 2.3.3.5: Suture Technique, 2004-2007 2004 (N=138) 2005 (N=192) 2006 (N=177) 2007 (N=189) Total (N=696) Suture TechniqueNo.% % % % % Interrupted only1329613973123691327052675 Continuous only0000531061 Combined641891911 6548 No data0035183017452411016

13. Table 2.4.1: Stock and Flow - Graft status (whole database)

14. Figure 2.4.2.1: Graft Survival, 2004-2007 Table 2.4.2.1: Graft Survival, 2004-2007* Interval (months)No.% successSE 0378100- 12303802 24103723 3631654 4855511 Outcome data were not submitted for 192 corneal transplant patients in year 2004-2006, while outcome data at 1 year for 172 corneal transplant patients with notification in year 2007 is still on going

15. Figure 2.4.2.2: Graft Survival by Optical and Non-optical Indication, 2004-2007 Table 2.4.2.2: Graft Survival by Optical and Non-optical Indication, 2004-2007 OpticalNon-Optical Interval (months)No.% successSENo.% successSE 0258100-120100- 1222989274604 248480319536 36267255536 48354162536 Outcome data were not submitted for 192 corneal transplant patients in year 2004-2006, while outcome data at 1 year for 172 corneal transplant patients with notification in year 2007 is still on going

16. Figure 2.4.2.3 Graft Success by Gender, 2004-2007 Table 2.4.2.3 Graft Success by Gender, 2004-2007 MaleFemale Interval (months)No.% successSENo.% successSE 0237100-141100- 12189793114803 245671447734 362065511667 485655--.- Outcome data were not submitted for 192 corneal transplant patients in year 2004-2006, while outcome data at 1 year for 172 corneal transplant patients with notification in year 2007 is still on going.

17. Table 2.4.2.4 Graft Survival by Age, 2004-2007 0-910-19 Interval (months)No.% successSENo.% successSE 07100-16100- 12 6 8613 8110 24 1 433188110 36 - --58110 48 - ----- 20-39≥40 Interval (months)No.% successSENo.% successSE 019100-336100- 1216848268792 24584889713 36384823635 48184845012 Outcome data were not submitted for 192 corneal transplant patients in year 2004-2006, while outcome data at 1 year for 172 corneal transplant patients with notification in year 2007 is still on going. Figure 2.4.2.4 Graft Survival by Age, 2004-2007

18. Table 2.4.2.5: Causes of Graft Failure Total (N=94) No.% Graft Failure9425 Cause of Failure Primary graft failure or Primary Endothelial decompensation1617 Recurrence of primary disease66 Late Endothelial decompensation1920 Glaucoma1314 Infection1819 Graft rejection2223 Others2527 No data89 *Each Patient may have more than one cause of graft failure. 56 patients have 1 cause 28 patients have 2 causes 1 patient has 3 causes 1 patient has 4 causes

19. Table 2.4.3.1: Availability of Data on Post Corneal Transplant Unaided Vision Unaided Vision (N =742) No.% Data available 32644 Lost to follow up 30641 No data 11015 Table 2.4.3.2 Unaided Visual Outcome After Cornea Transplant Surgery Reason for graft Optical (228) Non-optical (98) n%n% Vision better 107474647 Vision same 40172526 Vision worse 271220 Not known* 542477 * Either pre op vision and/or post op vision is not available Figure 2.4.3.2 Unaided Visual Outcome After Corneal Transplant Surgery

20. Table 2.4.3.3 Unaided Vision for Optical and Non Optical Cases Optical Non Optical VisionGraft Survival (192) Graft Failure (36) Graft Survival (58) Graft Failure (40) n%n%n%n% 6/18 or Better 5227 00 915 13 6/24 – 6/60 7941 00 2136 13 Less than 6/60 5931 36100 2747 3894 Data not available 21001200 Figure 2.4.3.3 Cumulative Probability for Unaided Vision in Grafts

21. Table 2.5.1: Post Transplant Complications One year outcome (N=275) 2 nd year outcome (N=72) 3 rd year outcome (N=26) 4 th year outcome (N=5) Total (N=378) No.% % % % % Any complications15754248243 Complication Epithelial Problem281847281133514 Wound Dehiscence2100000021 Suture infiltration / abscess1510362800208 Endophthalmitis1112000021 Microbial keratitis1711240000198 Vascularisation28184700003213 Post-keratoplasty glaucoma28189173131 4117 Graft Rejection26175900003113 No data62393259177167511748 * Each patient may have more than one complication Table 2.5.2: Post Transplant Graft Rejection Types One year outcome (N=275) 2 nd year outcome (N=72) 3 rd year outcome (N=26) 4 th year outcome (N=5) Total (N = 378) No.% % % % % Graft Rejection2650031 Types Epithelial103824000001239 Stromal623000000619 Endothelial114236000001445 No data415000000413 * Each patient may have more than one type of rejection