Abstract
Purpose The aim of the study is to evaluate the donor characteristics on Descemet Membrane endothelial keratoplasty (DMEK) outcome to identify, if possible, the risk factors for unsuccessful preparation.
Methods A retrospective analysis was performed on a prospective database of FBOV tissues prepared for DMEK from January 2019 to October 2023. A total of 2205 grafts prepared from 1441 donors were analyzed and the principal characteristics were evaluated. Statistical analysis was performed to identify the risk factors for unsuccessful preparation of donor tissue for DMEK.
Results Analyzing the following groups, successful (S-DMEK, N=2114; 95.9%) and unsuccessful (U-DMEK, N=91, 4.1%) DMEK, there are apparently no significant differences respect the type of donation (NB vs NHB), corneas from septic and not septic donors, corneas from donors undergoing and not-undergoing brain radiotherapy and among the days in organ culture.
There was a significant difference between the above-mentioned groups (S-DMEK vs U-DMEK) in term of gender (Male: S-DMEK 61%, U-DMEK 78%, p=0.001), age (Age<60yr S-DMEK 10.1%, U-DMEK 16.5%, Age 60-69: S-DMEK 47.5%, U-DMEK 33%, Age>=70yr: S-DMEK 42.4%, U-DMEK 50.5%, p=0.013), post-mortem interval (hours) (S-DMEK median 11.1, IQR 10.4 vs U-DMEK median 12.6, IQR 11.5, p=0.030), days in transport (S-DMEK median 2, IQR 1.03 vs U-DMEK median 2.04, IQR 0.30, p=0.040) and endothelial density before DMEK graft preparation (S-DMEK median 2500, IQR 200 vs U-DMEK median 2400, IQR 200, p=0.031). The analysis also shows that corneas from donors with diabetes mellitus have a higher risk of DMEK’s failure (OR 4.026, CI95% 2.567-6.314).
Conclusions The study suggests that donor and eye bank factors have a significant impact on Descemet Membrane endothelial keratoplasty graft preparation, in particular diabetes seems to be a risk factor for unsuccessful preparation. Acting on these factors could be useful to improve the outcome of DMEK preparation and reduce the rate of graft failure.
