Impact of Donor Characteristics on 2-Year DSEK Outcomes in Fuchs Dystrophy Patients
Narrative Responses:
Purpose
To determine the relationship between donor cornea death to preservation time, donor cornea storage time, donor cornea endothelial cell density, and donor cornea age on post-operative endothelial cell density (ECD) 2 years post-operatively after descemets-stripping endothelial keratoplasty (DSEK) in patients with Fuchs dystrophy.
Methods
This is a retrospective chart review of 70 eyes with two-year follow-up who underwent DSEK for Fuchs dystrophy in a single group practice. Patients with glaucoma were excluded from the study. All donor cornea information was obtained from the local eye bank. Post-operative ECD was obtained using the Konan non-contact specular microscope utilizing center method. Statistical analysis was performed using multiple linear regression and stepwise regression.
Results
Linear regression identified donor cornea age as a predictor of post-operative ECD at post-operative years 1 and 2 (p=0.0176, R2=0.076 and p=0.0015, R2=0.131 respectively). Donor cornea death to preservation was a predictor of post-operative ECD at post-operative year 2 (p=0.0346, R2=0.0627). Donor cornea storage time and donor ECD did not significantly impact post-operative ECD. Stepwise regression also identified donor age as a statistically significant predictor of post-operative ECD at years 1 and 2 after taking into account donor ECD, death to preservation time, and cornea storage time (alpha to include set 0.15 with p=0.021 and p=0.002, respectively).
Conclusion
Younger donor age appears to be a statistically significant predictor of higher post-operative ECD in Fuchs dystrophy patients after DSEK. Our data also weakly suggests longer death to preservation time is associated with higher post-operative ECD at post-operative year 2.