Bibliometric Factors and Sentiment as Predictors of Lamellar Keratoplasty Trends in the United States

Objective: To evaluate the relationship of scientific publication factors to lamellar keratoplasty volume in the United States (USA). Methods: Bibliometric analysis was performed using the R package, Bibliometrix, on the Scopus citation database to analyze trends in literature regarding Descemet's stripping automated endothelial keratoplasty (DSAEK), Descemet's membrane endothelial keratoplasty (DMEK), and deep anterior lamellar keratoplasty, and compared with published reports from the Eye Bank Association of America. Results: Our search yielded 1,356 DSAEK articles published between 2004 and 2023 with an annual overall percentage growth rate of 27.65%. There were 1,622 DMEK published articles between 2006 and 2023 with an annual overall percentage growth rate of 35.64%. The most productive countries by corresponding author were the United States (388), Japan (99), and Italy (68) for DSAEK compared with Germany (310), the United States (274), and the Netherlands (133) for DMEK. Eye Bank Association of America data demonstrated relatively rapid adoption of DSAEK in the United States, while DMEK sustained a slower, steadier increase in surgeries. Conclusion: DSAEK seems to be predominantly a US-first phenomenon with rapid adoption and surgeries outpacing the rate of global publications. DMEK seems to be predominantly a European-first technique with a more diverse origin of publications which outpaced the relatively slower surgical rate in the United States.