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Donor-Related Risk Factors and Preoperative Recipient-Related Risk Factors for Graft Failure

Yu, Alice L. MD*; Kaiser, Michaela*; Schaumberger, Markus PhD*; Messmer, Elisabeth MD*; Kook, Daniel MD*; Welge-Lussen, Ulrich MD

doi: 10.1097/ICO.0000000000000225
Clinical Science

Purpose: The aim of this study was to evaluate the outcome of penetrating keratoplasties, at the University Eye Hospital, Ludwig-Maximilians-University, Munich, Germany, using organ-cultured donor corneas and to identify preoperative risk factors, which may influence the event of graft failure.

Methods: In this study, 377 medical records of patients, who underwent penetrating keratoplasty between 2001 and 2011, were reviewed. Organ-cultured donor corneas were obtained from the eye bank, Ludwig-Maximilians-University, Munich, Germany. Donor-related and preoperative recipient-related risk factors for graft failure were analyzed by univariate and multivariate analyses.

Results: Graft failure occurred in 26% of patients. The following preoperative factors were significantly associated with graft failure by multivariate analyses: high donor age, low donor endothelial cell density, high patient age, indications of infectious keratitis, acute perforation of noninfectious keratitis, prior graft failure, chemical burn, trauma, glaucoma-associated corneal decompensation, high-risk graft indications, corneal edema, anterior chamber lens, diabetes mellitus, atopy, and autoimmune diseases.

Conclusions: This study demonstrated a success rate of 74%, which is consistent with previous studies. Various preoperative recipient-related factors seem to influence the outcome of penetrating keratoplasties, whereas few donor-related factors have a significant association with graft failure.

*Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany; and

Department of Ophthalmology, Friedrich-Alexander-University, Erlangen, Germany.

Reprints: Alice L. Yu, MD, Department of Ophthalmology, Ludwig-Maximilians-University, Mathildenstrasse 8, 80336 Munich, Germany (e-mail:

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

Received April 10, 2014

Received in revised form June 22, 2014

Accepted June 27, 2014

© 2014 by Lippincott Williams & Wilkins.