Abstract
Purpose:
To identify factors associated with thickness of eye bank-prepared DSAEK grafts.
Methods:
Data from all corneal tissues processed for DSAEK at a single eye bank from 2008-2012 were included (n= 7,668). Multivariate linear regression modeling was used to identify factors contributing to thickness of DSAEK grafts.
Results:
Eye bank-prepared DSAEK grafts have become thinner over time, on average 48 microns thinner in 2012 than in 2008. Decreased pre-processing corneal thickness and higher pre-processing endothelial cell density were associated with thinner lamellar grafts (p<0.0001), but post-processing cell density and graft diameter were not associated with graft thickness (p=0.70 and p=0.88). Older donor age was associated with thinner grafts (p<0.0001). There was no significant interaction between donor age and endothelial cell density in relation to final graft thickness (p=0.161). Death-to-procurement time and death-to-processing time were not associated with graft thickness (p=0.94 and p=0.93). DSAEK grafts processed during the “work-day” (8a-5p) were on average 3.8 microns thinner than those processed “after-hours” (5p-8a; p<0.0001). In comparing technician experience, no significant difference was found between number of tissues processed and post-processing thickness.
Conclusions:
Eye bank-prepared DSAEK graft thickness has decreased over time, and thinner grafts were associated with thinner corneal tissue, increased endothelial cell density, increased donor age, and daytime tissue preparation. There was no association between graft thickness and death-to-procurement time, death-to-processing time, or technician experience.
Keywords: 479 cornea: clinical science •
741 transplantation