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Impact of Donor Characteristics on 2-Year Descemet Stripping Automated Endothelial Keratoplasty Outcomes in Patients With Fuchs Endothelial Dystrophy

Hesham, Nadia MD; Schultze, Robert L. MD

doi: 10.1097/ICO.0000000000000302
Clinical Science

Purpose: The aim of this study was to determine the relationship between donor tissue characteristics and surgical outcomes in patients with Fuchs endothelial dystrophy (FED) 2 years after undergoing Descemet stripping automated endothelial keratoplasty (DSAEK).

Methods: A retrospective chart review was performed identifying 70 eyes with FED that underwent DSAEK. Donor endothelial cell density (ECD), donor death to preservation time, donor storage time, donor age, and postoperative recipient ECD were evaluated. Statistical analysis was performed using univariate linear regression analysis and bidirectional elimination multiple stepwise linear regression.

Results: Cornea donor age was a predictor of postoperative ECD at postoperative years 1 and 2 (P = 0.02, adjusted R2 = 0.07 and P = 0.002, adjusted R2 = 0.13, respectively). Donor age was also a predictor of postoperative ECD at years 1 and 2 after taking into account donor ECD, death to preservation time, and donor storage time (P = 0.02, adjusted R2 = 0.62 and P = 0.002, adjusted R2 = 0.12, respectively). Donor death to preservation time was a predictor of postoperative ECD at only postoperative year 2 (P = 0.03, adjusted R2 = 0.05). Donor storage time and donor ECD did not significantly impact postoperative ECD.

Conclusions: Although donor age seems to have a statistically significant impact on postoperative ECD in patients with FED undergoing DSAEK, the relationship is weak. Other donor parameters did not have a consistent or significant impact on postoperative ECD.

Albany Medical College, Albany, NY.

Reprints: Nadia Hesham, MD, Lion's Eye Institute, 1220 New Scotland Avenue, Slingerlands, New York 12159 (e-mail:

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

Received May 18, 2014

Received in revised form September 08, 2014

Accepted September 26, 2014

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