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Am J Ophthalmol. 2015 May;159(5):829-34.e2. doi: 10.1016/j.ajo.2015.01.030. Epub 2015 Jan 30.

Risk factors for eye bank preparation failure of Descemet membrane endothelial keratoplasty tissue.

Author information

1
Cornea and Anterior Segment Service, Wilmer Eye Institute, Johns Hopkins Medical School, Baltimore, Maryland.
2
Lions VisionGift, Portland, Oregon.
3
Lions VisionGift, Portland, Oregon; Corneal Services, Devers Eye Institute, Portland, Oregon.
4
Oncology Center-Biostatistics/Bioinformatics, Johns Hopkins University, Baltimore, Maryland.
5
Department of Ophthalmology, Federal University of São Paulo/Paulista School of Medicine, São Paulo, Brazil.
6
Cornea and Anterior Segment Service, Wilmer Eye Institute, Johns Hopkins Medical School, Baltimore, Maryland. Electronic address: aljun@jhmi.edu.

Abstract

PURPOSE:

To assess the results of a single eye bank preparing a high volume of Descemet membrane endothelial keratoplasty (DMEK) tissues using multiple technicians to provide an overview of the experience and to identify possible risk factors for DMEK preparation failure.

DESIGN:

Cross-sectional study.

METHODS:

setting: Lions VisionGift and Wilmer Eye Institute at Johns Hopkins Hospital.

STUDY POPULATION:

All 563 corneal tissues processed by technicians at Lions VisionGift for DMEK between October 2011 and May 2014 inclusive.

OBSERVATION PROCEDURES:

Tissues were divided into 2 groups: DMEK preparation success and DMEK preparation failure.

MAIN OUTCOME MEASURES:

We compared donor characteristics, including past medical history.

RESULTS:

The overall tissue preparation failure rate was 5.2%. Univariate analysis showed diabetes mellitus (P = .000028) and its duration (P = .023), hypertension (P = .021), and hyperlipidemia or obesity (P = .0004) were more common in the failure group. Multivariate analysis showed diabetes mellitus (P = .0001) and hyperlipidemia or obesity (P = .0142) were more common in the failure group. Elimination of tissues from donors either with diabetes or with hyperlipidemia or obesity reduced the failure rate from 5.2% to 2.2%. Trends toward lower failure rates occurring with increased technician experience also were found.

CONCLUSIONS:

Our work showed that tissues from donors with diabetes mellitus (especially with longer disease duration) and hyperlipidemia or obesity were associated with higher failure rates in DMEK preparation. Elimination of tissues from donors either with diabetes mellitus or with hyperlipidemia or obesity reduced the failure rate. In addition, our data may provide useful initial guidelines and benchmark values for eye banks seeking to establish and maintain DMEK programs.

PMID:
25640409
PMCID:
PMC4856026
DOI:
10.1016/j.ajo.2015.01.030
[Indexed for MEDLINE]
Free PMC Article

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