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Gabriel M Rand, Isaac Marco Chocron, Jimmy Yan Hu, Patrick Gore, Lynn Forest-Smith, Tina Livesay, Roy S Chuck; Diabetes mellitus in eye bank donors does not impact corneal transplant suitability. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2889.
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© ARVO (1962-2015); The Authors (2016-present)
There is controversy over the quality of corneal transplant tissues from diabetic donors entering US eye banks. Hypothesized mechanisms of injury include in-vivo cellular toxicity and ex-vivo damage during procurement and processing. We performed a retrospective analysis to determine if corneas from diabetic donors were more likely to be marked unsuitable for surgical use based upon poor Descemet membrane (DM) or endothelial cell ratings.
De-identified cornea donor data was supplied from Saving Sight of Kansas City, Missouri (2011-2015). The data set contained information on 13,659 donated corneas including donor demographics, medical history, time from death to preservation of the cornea, lens status, endothelial cell count (ECD), and suitability for transplantation. Primary outcomes were suitability for transplant and slit lamp and specular microscopy tissue analyses.
Among 2,722 donors (mean [SD] age, 57.7 [14.8] years; 1,690 men and 1,032 women), the percent of unsuitable corneas based on analysis of endothelium and DM was 13.3%. Reasons for unsuitability included poor tissue unmeasurable by specular microscopy (2.4%), low measurable cell count (77.2%), poor morphology (1.4%), tears/breaks (1.4%), and guttata (2.1%). After adjusting for age, race, sex, lens status, and time from death to preservation, the presence of diabetes was neither associated with overall endothelial or DM tissue unsuitability (adjusted odds ratio, 1.13; 95% CI, 0.94-1.36; P = .17) nor with poor tissue secondary to unmeasurable cell count (adjusted odds ratio, 2.79; 95% CI, 0.24-32.18; P = .41), low measurable cell count (adjusted odds ratio, 1.03; 95% CI, 0.69-1.52; P = .88), poor morphology (adjusted odds ratio, 0.87; 95% CI, 0.30-2.54; P = .80), tears/breaks (adjusted odds ratio, 1.02; 95% CI, 0.32-3.25; P = .96), or guttata (adjusted odds ratio, 1.37; 95% CI, 0.38-4.87; P = .62).
The presence of diabetes was not significantly associated with reduced transplant suitability. This study is consistent with previous studies and supports the continued preservation of the diabetic donor pool.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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