Abstract
<title>Abstract</title> <p> <bold>Purpose</bold> : To evaluate trends in indications and surgical techniques of corneal transplantation in Morocco over 15 years. <bold>Methods</bold> : Retrospective study including all consecutive corneal transplantations performed at a tertiary referral centre in Rabat- Morocco between 2010 and 2024. Demographic characteristics, surgical indications, graft techniques, and temporal trends were analyzed. <bold>Results</bold> : A total of 3,097 corneal transplantations were performed. Corneal ectasia remained the leading indication of corneal graft (47.8%), followed by bullous keratopathy (20.2%) and corneal scars (11.3%). The proportion of ectatic diseases declined over time (57.4% in 2014 vs. 36.8% in 2024), whereas bullous keratopathy and Fuchs endothelial dystrophy increased significantly (p<0.001). Penetrating keratoplasty remained the most common procedure (70.0%) but decreased from 97.4% in 2010 to 57.0% in 2024. DALK accounted for 20.8% of procedures, while DMEK expanded rapidly after its introduction, representing 23.4% of grafts in 2024. <bold>Conclusions</bold> : Corneal transplantation in Morocco is undergoing a major epidemiological and surgical transition. Although keratoconus remains the predominant indication, endothelial disorders are increasing and progressively reshaping surgical practice, with growing adoption of lamellar and endothelial keratoplasty techniques. </p>