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Influence of Preoperative Donor Tissue Characteristics on Graft Dislocation Rate After Descemet Stripping Automated Endothelial Keratoplasty

Hood, Christopher T. MD; Woodward, Maria A. MD; Bullard, Michael L. MD; Shtein, Roni M. MD, MS

doi: 10.1097/ICO.0b013e3182a966b4
Clinical Science

Purpose: To determine the influence of preoperative donor tissue characteristics on the graft dislocation rate after performing a Descemet stripping automated endothelial keratoplasty (DSAEK).

Methods: We retrospectively analyzed the associations between donor tissue characteristics and graft dislocation rates for consecutive DSAEK surgeries performed in a 4-year period at a single institution.

Results: From June 2007 to June 2011, 64 (18%) of 355 eyes underwent a procedure for graft dislocation. There were no differences in donor age, preoperative endothelial graft thickness, preprocessing endothelial cell density, change in endothelial cell density after processing, time from death to tissue processing, or time from tissue processing to surgery between eyes that experienced dislocations and those that did not (P > 0.05 for each). The graft recipient's corneal disease diagnosis, preoperative corneal thickness, preoperative visual acuity, glaucoma status, history of glaucoma surgery, and cataract surgery at the time of performing the DSAEK were not associated with an increased rate of dislocation (P > 0.05 for each). Recipients who experienced graft dislocation were significantly older (73.6 vs. 70.2 years, P = 0.03) and more likely to undergo subsequent repeat transplantation (29.7% vs. 10.7%, P < 0.0001).

Conclusions: We found no correlation between any corneal donor tissue characteristic and graft dislocation after the DSAEK was performed. Graft dislocation was more common in older recipients. Patients with dislocation had a higher rate of subsequent transplantation.

Department of Ophthalmology and Visual Sciences, University of Michigan W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, MI.

Reprints: Roni M. Shtein, University of Michigan Kellogg Eye Center, 1000 Wall St, Ann Arbor, MI 48105 (e-mail:

Supported by NIH/NEI EY017885 (R.M.S.) and the Midwest Eye Bank. The funding agencies had no role in the design or conduct of this research.

Presented in part at ARVO 2012 (Ft Lauderdale, FL).

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

Received June 03, 2013

Accepted August 16, 2013

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.