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D. J. Friend, N. Shamie, E. Chen, M. Terry; Endothelial Keratoplasty and Eye Banking: Do Donor Variables Influence Surgical Success?. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4718.
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There is concern among endothelial keratoplasty (EK) surgeons that donor tissue with longer storage time and lower cell counts may pose a higher risk for dislocation, primary graft failure, and greater endothelial cell loss over time. We evaluated donor variables and their influence on surgical outcomes in a large EK series.
Donor data on 303 EK grafts were obtained with assignment of donor pre-operative cell count, death to preservation time, death to implantation time and donor age. A multitude of statistical analyses tests were conducted to examine whether these donor characteristics were related in any way to dislocation and rejection rate as well as percentage of cell loss at six months.
Correlation analysis revealed no significant correlations between any of the variables. MANOVA and discriminate function analyses revealed no differences between those patients that had graft dislocations vs. those who did not. There was no difference between those patients that experienced graft rejection vs. those who did not. A logistic regression revealed no significant odds ratio increase when dislocation and rejection rates were compared across donor characteristics. Finally, a linear regression revealed that donor characteristics did not significantly predict the percentage of cell loss at six months.
Donor variables do not influence dislocations, rejection rate, or endothelial survival. Meticulous attention to surgical technique to minimize endothelial trauma will likely yield greater patient benefit than surgeon requests for younger and fresher donor tissue with exceptionally high cell counts.
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