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Diabetes Mellitus Increases Risk of Unsuccessful Graft Preparation in Descemet Membrane Endothelial Keratoplasty
- Source :
- Cornea. 33:1129-1133
- Publication Year :
- 2014
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2014.
-
Abstract
- The aim of this study was to evaluate preparation outcomes of tissue prepared for Descemet membrane endothelial keratoplasty (DMEK) from diabetic and nondiabetic donors.In this nonrandomized, consecutive case series, DMEK grafts were prepared from diabetic and nondiabetic donors by experienced technicians in 2 eye banks using slightly different, modified submerged manual preparation techniques to achieve "prestripped" graft tissue. Graft preparation results were analyzed retrospectively. The main outcome measure was the rate of unsuccessful (failed) DMEK graft preparations, defined as tears through the graft area that prevent tissue use.A total of 359 corneas prepared from 290 donors (114 diabetic and 245 nondiabetic) were included in the statistical analysis of graft preparation failure. There were no significant differences between diabetic and nondiabetic donor tissue characteristics with respect to donor age, death to preservation time, death to preparation time, endothelial cell density, percent hexagonality, or coefficient of variation. DMEK tissue preparation was unsuccessful in 19 (5.3%) cases. There was a significant difference in the site-adjusted rate of DMEK preparation failure between diabetic [15.3%; 95% confidence interval (CI), 9.0-25.0] and nondiabetic donors (1.9%; 95% CI, 0.8-4.8), and the corresponding site-adjusted odds ratio of DMEK graft preparation failure in diabetic donor tissue versus nondiabetic donor tissue was 9.20 (95% CI, 2.89-29.32; P = 0.001).Diabetes may be a risk factor for unsuccessful preparation of donor tissue for DMEK. We recommend caution in the use of diabetic tissue for DMEK graft preparation. Further study is needed to identify what subset of diabetic donors is at risk for unsuccessful DMEK graft preparation.
- Subjects :
- Male
medicine.medical_specialty
Endothelium
Descemet membrane
Eye Banks
Specimen Handling
Diabetes Complications
Risk Factors
Diabetes mellitus
Diabetes Mellitus
Humans
Medicine
Descemet Membrane
Aged
Retrospective Studies
business.industry
Endothelium, Corneal
Graft Survival
Retrospective cohort study
Consecutive case series
Middle Aged
medicine.disease
Tissue Donors
Surgery
Ophthalmology
medicine.anatomical_structure
Multicenter study
Descemet Stripping Endothelial Keratoplasty
Female
Graft survival
business
Subjects
Details
- ISSN :
- 02773740
- Volume :
- 33
- Database :
- OpenAIRE
- Journal :
- Cornea
- Accession number :
- edsair.doi.dedup.....a19fea3cfad0b652a05f27f23a03253c