Abstract
Purpose :
Surgeons are selective on what donor tissue characteristics they will accept for Descemet membrane endothelial keratoplasty (DMEK) surgery. There has been no 5 year study evaluating if diabetic donor grafts are as successful as non-diabetic donor grafts. The purpose of this study is to compare long-term outcomes of DMEK grafts from non-diabetic donors and diabetic donors.
Methods :
A consecutive series of 1262 DMEK surgeries for Fuchs’ dystrophy from 9/2013-9/2022 was retrospectively analyzed. Five-year clinical outcomes of endothelial cell loss (ECL), best spectacle corrected visual acuity (BSCVA), central corneal thickness (CCT), and graft failures were compared for DMEK grafts from non-diabetic donors vs DMEK grafts from diabetic donors. A Student's t-test or chi-square test was used to determine statistical significance. Imported grafts from other eye banks were excluded because donor diabetic status could not be verified.
Results :
A total of 139 eyes in the non-diabetic group and 37 eyes in the diabetic group had 5-year data available. Five-year ECL for non-diabetic grafts was 54.6%±17.4% and 54.1%±16.5% for diabetic grafts, p=0.87. Five-year BSCVA for non-diabetic grafts and diabetic grafts was 20/23 vs 20/23, p=0.68. Percent change in CCT from preop to 5-years postoperative was 12.3%±8.9% thinner in non-diabetic grafts and 10.9%±7.5% thinner in diabetic grafts, p=0.50. Graft failures in the first 5 postoperative years from all 1262 consecutive surgeries, either primary graft failures or late endothelial failures, occurred in 1.4% (14/978) in the non-diabetic group and 1.1% (3/284) in the diabetic group, p=0.63.
Conclusions :
There was no statistically significant difference in 5 year ECL, BSCVA, percent change in CCT from preop, and graft failures in DMEK grafts from non-diabetic donors and diabetic donors. These findings suggest that donor tissue selection for DMEK surgery should not be influenced by donor diabetic status.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.