Abstract
Purpose :
In Descemet membrane endothelial keratoplasty (DMEK), some corneal centers recently reported that some eyes showed a decrease in endothelial cell density (ECD) that could not be attributed to preparation or surgical trauma. Thus, we hypothesized that donor- and tissue-related parameters can correlate with short-term ECD reduction.
Methods :
In this retrospective case series we included 16 consecutive cases that had undergone DMEK at the Eye Hospital, University Clinical Centre Ljubljana, Slovenia. Preoperatively we analyzed the following donor- and tissue-related parameters: time from death to preservation, hypothermic preservation time, ECD, donor age and gender. All operations were performed by the same corneal surgeon (PS) as was the ECD count one and six months after surgery. We performed correlation and regression analysis between the preoperative parameters and the ECD at 1 and 6 months after transplantation.
Results :
We analyzed 16 patients, 1 patient was excluded due to high variations in values. The mean donor age was 72.8±10.3 years, the mean time from donor death to preservation was 8.0±3.4 h, the mean preservation time was 97.8±51.3 h, and the mean pre-preparation ECD was 2899±316 cells/mm2. We observed a 22.7±7.8% ECD decline 1 month after the surgery and 26.4±7.0% 6 months after DMEK. Correlation and regression analysis showed that donor age might be associated with an ECD decrease after 6 months (borderline statistically significant, p=0.051), but not after 1 month (p=0.287) (i.e., lower donor age seems to be associated with lower ECD decline after 6 months). In addition, correlation and regression analysis indicated that time from death to preservation might influence ECD decrease 1 month postoperatively (p=0.015), but not after 6 months (p=0.250). No statistically significant correlation was found between donor gender, pre-preparation ECD, and storage time.
Conclusions :
We showed an association between donor age and time from death to preparation and ECD decline after DMEK. Therefore, cornea harvesting times should be kept as short as possible to improve short-term ECDs. More research is needed to draw definite conclusions on the possible effect of other donor- and tissue-related parameters.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.