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Descemet's membrane endothelial keratoplasty outcomes using corneas from septic donors

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First Author: M.Quilendrino THE NETHERLANDS

Co Author(s):    I. Vasiliuskate   M. de Jong   J. van der Wees   S. Oellerich   G. Melles        

Abstract Details

Purpose:

To evaluate the suitability of corneas from septic donors for corneal transplantation by analysing the discard rate in the eye bank and the clinical outcome of Descemet Membrane Endothelial keratoplasty (DMEK) using organ-cultured corneal grafts from septic versus non-septic donors.

Setting:

Retrospective, interventional case series conducted at the Netherlands Institute for Innovative Ocular Surgery

Methods:

This retrospective study included 1554 corneas received by Amnitrans Eye Bank Rotterdam between January and October 2018 of which 456 corneas (29%) were from septic and 1072 corneas (69%) from non-septic donors (for 26 corneas (2%) sepsis status was unknown). Clinical outcome at 6 months after DMEK was evaluated for 82 grafts (26 from septic and 56 from non-septic donors). Outcome measures were endothelial cell density (ECD), central corneal thickness (CCT) and postoperative complications.

Results:

Primary discard rates were higher for corneas from septic than from non-septic donors (32.9% vs 24.5%, P=0.001). Main discard reason was poor endothelial cell quality for both septic (13.8%) and non-septic (11.8%) donor corneas. After DMEK, donor ECD at 6m postoperatively was comparable between grafts from septic and non-septic donors (1410 ±422 cells/mm2 vs 1590 ±519 cells/mm2, P=0.140). No differences in 6m CCT and in the re-bubbling rate were observed between the two groups (P=0.780 and P=0.396, respectively). None of the cases had graft rejection nor endophthalmitis in both groups.

Conclusions:

Provided strict adherence to donor screening and evaluation protocols, the use of organ-cultured corneas from septic donors for DMEK does not seem to increase the risk for recipients and allows for expansion of the donor pool for corneal tissue.

Financial Disclosure:

... receives non-monetary benefits from a company producing, developing or supplying the product or procedure presented