Universität zu Köln

Schaub, Friederike, Enders, Philip ORCID: 0000-0002-9527-4957, Adler, Werner ORCID: 0000-0001-9791-5407, Bachmann, Bjoern O., Cursiefen, Claus and Heindl, Ludwig M. (2017). Impact of donor graft quality on deep anterior lamellar Keratoplasty (DALK). BMC Ophthalmol., 17. LONDON: BIOMED CENTRAL LTD. ISSN 1471-2415

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Abstract

Background: To evaluate main features of donor tissue that may influence clinical outcome or complication rate after deep anterior lamellar keratoplasty (DALK). Methods: Donor tissue parameters of 84 consecutive corneal donor grafts used for big-bubble DALK surgery between June 2011 and December 2014 in 84 eyes of 84 patients with disorders of anterior corneal stroma were correlated to clinical outcome parameters of recipient eyes 12 months after surgery and 3 months after total suture removal. Main donor tissue parameters included age), post-mortem time, overall preservation time, preservation time after split and prior to transplantation, and preservation technique. Clinical outcome parameters included best spectacle corrected visual acuity (BSCVA), central corneal thickness (CCT), endothelial cell density (ECD) and complication rates. Pearson's correlation, linear regression analysis for clinical outcome parameter and logistic regression analysis for postsurgical complication rates were applied. Results: Corneal donors were mean aged 67.4 +/- 12.5 years with a post-mortem time of 20.7 +/- 14.7 h and ECD of 2641. 0 +/- 362.8 cells/mm(2). Overall preservation time was 16.3 +/- 6.3 days. Recipients showed mean BSCVA 12 months postoperatively of 0.60 +/- 0.36 logMAR, endothelial cell loss was 4 +/- 16%, and central corneal thickness was 571. 7 +/- 54.2 mu m. 3 months after total removal of sutures, BSCVA was 0.20 +/- 0.10 logMAR, endothelial cell loss was 17 +/- 24%, and central corneal thickness was 590.9 +/- 55.5 mu m. Loosening of sutures occurred in 20%, and Descemet detachment in 16%. None of the clinical outcome parameters or complication rate after DALK showed a significant association with donor tissue parameters. Conclusions: Donor corneas, independent of excision techniques or preservation method, with donor age <= 88 years, post-mortem time <= 63 h, overall preservation time <= 14 days for cold storaged donor tissue and <= 35 days for organ culture, and preservation time after split prior to grafting <= 96 h, seem to be applicable as safe donor tissue for DALK surgery.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Schaub, Friederike UNSPECIFIED UNSPECIFIED UNSPECIFIED Enders, Philip UNSPECIFIED orcid.org/0000-0002-9527-4957 UNSPECIFIED Adler, Werner UNSPECIFIED orcid.org/0000-0001-9791-5407 UNSPECIFIED Bachmann, Bjoern O. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cursiefen, Claus UNSPECIFIED UNSPECIFIED UNSPECIFIED Heindl, Ludwig M. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-211121
DOI:	10.1186/s12886-017-0600-6
Journal or Publication Title:	BMC Ophthalmol.
Volume:	17
Date:	2017
Publisher:	BIOMED CENTRAL LTD
Place of Publication:	LONDON
ISSN:	1471-2415
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SPLIT-CORNEA TRANSPLANTATION; PENETRATING KERATOPLASTY; DESCEMETS-MEMBRANE; CLINICAL-OUTCOMES; TISSUE; KERATOCONUS; TRENDS; DMEK Multiple languages Ophthalmology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/21112