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Graft Survival of Diabetic Versus Nondiabetic Donor Tissue After Initial Keratoplasty

Vislisel, Jesse M. MD; Liaboe, Chase A. BA; Wagoner, Michael D. MD, PhD; Goins, Kenneth M. MD; Sutphin, John E. MD; Schmidt, Gregory A. BS, CEBT; Zimmerman, M. Bridget PhD; Greiner, Mark A. MD

doi: 10.1097/ICO.0000000000000378
Clinical Science

Purpose: To compare corneal graft survival using tissue from diabetic and nondiabetic donors in patients undergoing initial Descemet stripping automated endothelial keratoplasty (DSAEK) or penetrating keratoplasty (PKP).

Methods: A retrospective chart review of pseudophakic eyes that underwent DSAEK or PKP was performed. The primary outcome measure was graft failure. Cox proportional hazard regression and Kaplan–Meier survival analyses were used to compare diabetic versus nondiabetic donor tissue for all keratoplasty cases.

Results: A total of 183 eyes (136 DSAEK, 47 PKP) were included in the statistical analysis. Among 24 procedures performed using diabetic donor tissue, there were 4 cases (16.7%) of graft failure (3 DSAEK, 1 PKP), and among 159 procedures performed using nondiabetic donor tissue, there were 18 cases (11.3%) of graft failure (12 DSAEK, 6 PKP). Cox proportional hazard ratio of graft failure for all cases comparing diabetic with nondiabetic donor tissue was 1.69, but this difference was not statistically significant (95% confidence interval, 0.56–5.06; P = 0.348). There were no significant differences in Kaplan–Meier curves comparing diabetic with nondiabetic donor tissue for all cases (P = 0.380). Statistical analysis of graft failure by donor diabetes status within each procedure type was not possible because of the small number of graft failure events involving diabetic tissue.

Conclusions: We found similar rates of graft failure in all keratoplasty cases when comparing tissue from diabetic and nondiabetic donors, but further investigation is needed to determine whether diabetic donor tissue results in different graft failure rates after DSAEK compared with PKP.

*Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, IA;

Iowa Lions Eye Bank, Coralville, IA;

Department of Ophthalmology, Kansas University Medical Center, Kansas City, KS; and

§Department of Biostatistics, University of Iowa College of Public Health, Iowa City, IA.

Reprints: Mark A. Greiner, MD, Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, 200 Hawkins Dr, Iowa City, IA 52242 (e-mail: mark-greiner@uiowa.edu).

The authors have no funding or conflicts of interest to disclose.

Received November 26, 2014

Received in revised form December 16, 2014

Accepted December 17, 2014

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