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Brief Report |

Association Between Graft Storage Time and Donor Age With Endothelial Cell Density and Graft Adherence After Descemet Membrane Endothelial Keratoplasty

Marina Rodríguez-Calvo de Mora, MD1,2; Esther A. Groeneveld-van Beek, MSc1,3; Laurence E. Frank, PhD4; Jacqueline van der Wees, PhD1,3; Silke Oellerich, PhD1,2; Marieke Bruinsma, PhD1,2; Gerrit R. J. Melles, MD, PhD1,2,3
[+] Author Affiliations
1Netherlands Institute for Innovative Ocular Surgery (NIIOS), Rotterdam, the Netherlands
2Melles Cornea Clinic, Rotterdam, the Netherlands
3Amnitrans EyeBank, Rotterdam, the Netherlands
4Department of Methodology and Statistics, Utrecht University, Utrecht, the Netherlands
JAMA Ophthalmol. 2016;134(1):91-94. doi:10.1001/jamaophthalmol.2015.4499.
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Importance  After retrospectively evaluating the clinical outcome of 500 consecutive cases after Descemet membrane endothelial keratoplasty (DMEK), we extended the analysis in this study by assessing the effect of donor-related parameters on endothelial cell density (ECD) decline and detachment rate in this group.

Observations  This retrospective case series included 500 cases who had undergone DMEK from October 2007 to September 2012 at the Netherlands Institute for Innovative Ocular Surgery (NIIOS), Rotterdam, the Netherlands. Logistic regression analysis (n = 332 eyes) showed that donor age might be associated with a 3% increase in the risk for a detachment (odds ratio, 0.97; 95% CI, 0.94-1.00; P = .049) (ie, higher donor age seems to be associated with lower chances of a detachment). In addition, linear regression analysis indicated that graft storage time in medium was associated with ECD decrease (ie, the longer the storage time, the larger the decrease at 6 months after DMEK) (P = .01).

Conclusions and Relevance  We showed an association between graft storage time and ECD decline after DMEK and possibly between donor age and graft detachment. Therefore, donor storage times should be kept as short as possible to improve short-term ECDs. More research is needed to draw definite conclusions on the possible effect of donor age on the chance of a detachment after DMEK.

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Figure.
Regression Plots for the Outcomes of Detachment and Endothelial Cell Density (ECD) Decline

The effect plots are shown (A) for predictor donor age (years) and outcome probability of a detachment with 95% CIs (shaded region) and (B) for predictor storage time in medium (days) and outcome ECD decline at 6-month follow-up with 95% CIs (shaded region).

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