July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Effect of Donor Characteristics on Visual Outcomes and Endothelial Cell Count in the Descemet Endothelial Thickness Comparison Trial
Author Affiliations & Notes
  • Yijie Lin
    Ophthalmology, Proctor Foundation, UCSF, San Francisco, California, United States
    Department of Ophthalmology, University of California, San Francisco , San Francisco, California, United States
  • Winston Chamberlain
    Ophthalmology, Casey Eye Institute, Oregon Health Sciences University, Portland, Oregon, United States
  • Charles C Lin
    Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, California, United States
  • Ariana Austin
    Ophthalmology, Proctor Foundation, UCSF, San Francisco, California, United States
  • Nicholas Shubach
    Ophthalmology, Casey Eye Institute, Oregon Health Sciences University, Portland, Oregon, United States
  • Jameson Clover
    Lions VisionGift, Portland, California, United States
  • Stephen Mcleod
    Department of Ophthalmology, University of California, San Francisco , San Francisco, California, United States
  • Travis Porco
    Ophthalmology, Proctor Foundation, UCSF, San Francisco, California, United States
    Epidemiology and Biostatistics, University of California San Francisco , San Francisco, California, United States
  • Thomas Lietman
    Ophthalmology, Proctor Foundation, UCSF, San Francisco, California, United States
    Department of Ophthalmology, University of California, San Francisco , San Francisco, California, United States
  • Jennifer Rose-Nussbaumer
    Ophthalmology, Proctor Foundation, UCSF, San Francisco, California, United States
    Department of Ophthalmology, University of California, San Francisco , San Francisco, California, United States
  • Footnotes
    Commercial Relationships   Yijie Lin, None; Winston Chamberlain, None; Charles Lin, None; Ariana Austin, None; Nicholas Shubach, None; Jameson Clover, None; Stephen Mcleod, None; Travis Porco, None; Thomas Lietman, None; Jennifer Rose-Nussbaumer, None
  • Footnotes
    Support  National Eye Institute and Research to Prevent Blindness Grant K23 EY025025
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 2897. doi:
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      Yijie Lin, Winston Chamberlain, Charles C Lin, Ariana Austin, Nicholas Shubach, Jameson Clover, Stephen Mcleod, Travis Porco, Thomas Lietman, Jennifer Rose-Nussbaumer; Effect of Donor Characteristics on Visual Outcomes and Endothelial Cell Count in the Descemet Endothelial Thickness Comparison Trial. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2897.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Endothelial keratoplasty makes up more than 50% of the total corneal transplants in the United States. While descemet stripping automated endothelial keratoplasty (DSAEK) is the most common type, more recently, descemet membrane stripping keratoplasty (DMEK) (10-15 microns) has gained popularity.

The Descemet Endothelial Thickness Comparison Trial (DETECT) is a multicenter, double-masked, randomized controlled clinical trial analyzing the six-month visual outcome of participants who underwent Ultra-thin (UT)-DSAEK versus DMEK and found DMEK to be superior to UT-DSAEK. The purpose of this study is to assess whether various donor characteristics have an effect on the six-month visual outcome or endothelial cell count after endothelial keratoplasty.

Methods : 50 eyes with endothelial dysfunction were randomized to receive either UT-DSAEK or DMEK. The donor characteristics for each graft were recorded, including age, gender, endothelial cell count before and after processing, death to preservation time, death to surgery time and graft thickness for the DSAEK group. A logistic regression model was used to assess the relationship between these donor characteristics and six-month visual acuity and endothelial cell count controlling for baseline characteristics.

Results : We found no statistical difference in six-month visual outcome based on donor age, sex, endothelial cell count before or after processing, death to preservation time, death to surgery time, or graft thickness in the case of UT-DSAEK on visual acuity at 6 months (Table 1). We also found no effect of these characteristics on the endothelial cell count after 6 months (Table 2).

Conclusions : With the growing popularity of UT-DSAEK and DMEK, it is important to understand the effect that donor characteristics have on their outcomes. One limitation of our study was that it was powered to determine a visual acuity difference and may have been too small to detect an effect of various donor profiles on visual acuity or endothelial cell count. Future studies can aim to expand the participant size and analyze the two surgical groups separately.

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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