Author reply

We thank Hong et al for their comments regarding our manuscript and would like to address several important issues that they raise. The focus of our paper was specifically to study keratoplasty among patients with corneal endothelial disease (CED). Exploring keratoplasty for other corneal conditions such as keratoconus, ocular burns, and infectious keratitis was beyond the scope of our study. Although we acknowledge that expanding our study to capture patients with these other corneal conditions would offer readers a more global sense of outcomes of keratoplasty surgery, a downside to such an approach is that it may not fully reflect utilization patterns and outcomes of keratoplasty specifically for CED. In fact, others have demonstrated that patients who undergo keratoplasty for conditions such as keratoconus tend to have more favorable outcomes while those who undergo keratoplasty for chemical burns or other trauma tend to have worse outcomes than those with CED. We purposely excluded these groups from our analysis so they would not affect the findings of the group of interest to us, those with CED.