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Tissue Characteristics and Reported Adverse Events After Corneal Transplantation

Ple-plakon, Patricia A. MD*; Shtein, Roni M. MD*; Musch, David C. PhD, MPH*,†; Blachley, Taylor MS*; Saponara, Fiorella MD*,‡; Woodward, Maria A. MD*

doi: 10.1097/ICO.0b013e3182a0d154
Clinical Science

Purpose: To determine whether donor or tissue characteristics of corneas for transplantation are predictive of reported adverse events occurring in the early postoperative period.

Methods: We compared preoperative donor and tissue characteristics of corneal tissues with or without reported adverse events from 2007 to 2011. Adverse event categories included primary graft failure, infection, surgical causes, recipient-related etiologies, and other causes. We included corneas transplanted via penetrating keratoplasty (PK) and endothelial keratoplasty (EK).

Results: Of 20,431 tissues included, there were 251 (1.2%) reported adverse events. Among all transplanted tissues, 67% were used for PK, and 33% were used for EK. The adverse event occurrence rate was 0.78% in PK versus 2.12% in EK (P < 0.0001). The donor characteristics associated with adverse events were male gender (P = 0.01) and cancer history (P = 0.03), which were associated with primary graft failure. In PK, the most frequently reported causes within 106 adverse events were recipient-related causes (n = 41, 0.30% of total PK tissues) and infection (n = 31, 0.23%). In EK, the most frequently reported causes within 145 adverse events were surgical complications (n = 72, 1.05% of total EK tissues) and primary graft failure (n = 41, 0.60%).

Conclusions: The rate of reported adverse events was low. Adverse events more commonly occurred after EK. Increased rate of primary graft failure was associated with male donors and donors with a cancer history. Postcut tissue thickness, only in the year 2007, was the sole tissue characteristic associated with adverse events.

Author Information

Departments of *Ophthalmology and Visual Sciences, and

Epidemiology, University of Michigan, Ann Arbor, MI; and

Department of Ophthalmology, New York Presbyterian Hospital/Columbia University, New York, NY.

Reprints: Maria A. Woodward, Department of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, University of Michigan, 1000 Wall St, Ann Arbor, MI 4805 (e-mail:

Supported by Research to Prevent Blindness, Inc, New York, NY.

Dr. Woodward received funding from the Midwest Eye-Banks for laboratory tissue processing studies.

Received February 10, 2013

Accepted June 16, 2013

© 2013 by Lippincott Williams & Wilkins.