Abstract
Introduction Corneal transplantation is still the cornerstone of treatment for corneal blindness. However, hardly anything is known about the effects of new anti-cancer agents such as hormone therapy, immunotherapy and angiogenetic treatment on the quality of the donor cornea. While on the other hand corneal erosion is well known in the oncology ward.
Methods We extracted the data of patients with underlying cancer disease from our tissue management system EdgeCell (Inlog). We selected only those patients from the Antwerp University Hospital for the inventory of a variety of cancer treatments. Pearson’s chi square test was used with a significance level of .05.
Results A total of 1444 donors (median age 68.84 years) were registered in our digital system (858 males, 586 females). 713 donors had a cancer diagnosis, 731 donors with no malignancy. A total of 255 patients received their treatment within the Antwerp University Hospital.
Conclusion We have observed a significant association, albeit modest, between the gender of donors and the condition of their corneas, and also among donors with and without a history of cancer. Notably, this discrepancy is not evident within the subset of female donors, suggesting a possible influence of certain cancers and/or treatments on corneal integrity.
Our analysis did not identify a statistically significant difference in corneal quality between donors actively battling cancer and those with a cancer history. However, within the male donor subgroup, we did observe a notable disparity. The absence of a significant difference among female donors may be attributed to the effects of female sex hormones on corneal physiology.
Of particular note is the heightened risk of diminished corneal quality observed in donors diagnosed with lung cancer. This may be attributed to the aggressive nature of treatments such as radiotherapy, chemotherapy and immunotherapy, as well as the use of corticosteroids in concurrent COPD management.
Although based on limited sample sizes, there appears to be a trend towards lower corneal quality associated with multi-modal therapies involving tyrosine kinase inhibitors (TKI) and/or immunotherapy when compared to standard chemotherapy regimens.
Although the differences in corneal rejection percentages are rather small, some comparisons are statistically significant, and furthermore we have gained more insight in which donors have a better chance of having good quality corneas.
