Donor and recipient characteristics associated with rebubbling rate, endothelial cell loss, and graft failure in primary descemet membrane endothelial keratoplasty

Authors : Nesrin TUTAŞ GÜNAYDIN, Burak TANYILDIZ

Pages : 1461-1467

Doi:10.32322/jhsm.1158938

View : 23 | Download : 10

Publication Date : 2022-09-25

Article Type : Research Paper

Abstract :Aim: To determine whether donor and recipient characteristics are associated with rebubbling rate, endothelial cell loss insert ignore into journalissuearticles values(ECL);, and graft failure 3 years after primary Descemet membrane endothelial keratoplasty insert ignore into journalissuearticles values(DMEK);. Material and Method: Records of 295 consecutive DMEK surgery and match with corresponding donor data were reviewed at a tertiary referral clinic. Recipients with intraoperative complications and coexisting ocular pathologies were excluded. Age, sex of donor and recipient, cause of donor death, death-to-preservation time insert ignore into journalissuearticles values(DtPT);, storage time, donor endothelial cell density insert ignore into journalissuearticles values(ECD);, and indications for surgery were analyzed for correlation with rebubbling rate, postoperative ECL, and graft failure. Further, subgroup analyses of the cause of death, donor sex, DtPT insert ignore into journalissuearticles values(median value, 3.5 h);, and indications were performed. Multiple regression and receiver operating characteristics insert ignore into journalissuearticles values(ROC); analysis were used to determine the independent risk factors for graft failure. Results: This study included 114 eyes that underwent DMEK for bullous keratopathy insert ignore into journalissuearticles values(BK; 64%); and for Fuchs’ endothelial corneal dystrophy insert ignore into journalissuearticles values(FECD; 36%);. The graft failure percentage was the only parameter that was higher in patients with DtPT > 3.5 h insert ignore into journalissuearticles values(p=0.047); than those with shorter DtPT. The probability of graft failure was seven times higher in eyes with DtPT > 3.5 h than with shorter DtPT insert ignore into journalissuearticles values(odds ratio 7.36, 95% confidence interval CI 1.34‒40.53); and 10 times higher in eyes with BK than those with FECD insert ignore into journalissuearticles values(odds ratio 10.29, 95% CI 1.01‒104.54);. Conclusion:. DtPT and recipients with BK diagnosis were found to be independent risk factors for graft failure. Therefore, surgeons should consider DtPT for DMEK in eyes with BK.
Keywords : Descemet membrane endothelial keratoplasty, death to preservation time, graft failure, bullous keratopathy, Fuchs endothelial corneal dystrophy