biostudies-literatureUnknown9Nishisako S<h4>Aims</h4>To identify donor-related risk factors associated with graft endothelial failure and postoperative endothelial cell density (ECD) reduction after Descemet's stripping automated endothelial keratoplasty (DSAEK).<h4>Methods</h4>This was a single-center retrospective study conducted from July 2006-December 2016. We included 584 consecutive eyes (482 patients) that underwent DSAEK for the treatment of laser iridotomy-related bullous keratopathy (192 eyes), pseudophakic bullous keratopathy (137 eyes), regraft (96 eyes), Fuchs' endothelial corneal dystrophy (FECD; 59 eyes) and others (100 eyes). Twenty-three donor- and recipient-related risk factors potentially associated with graft failure and ECD reduction were assessed using Cox hazard models and linear mixed effect models.<h4>Results</h4>The median age of the patients was 73.5 years (male; 35.6%). After DSAEK, ECD decreased from 2,674 cells/mm² (95% confidence interval [CI]; 2,646-2,701) to 1,132 (1,076-1,190) at 12 months and 904 (845-963) at 24 months (<i>P</i> < 0.001). Fifty-five eyes (9.4%) had graft endothelial failure without rejection. This failure was associated with donor pseudophakic lens status (hazard ratio [HR]; 2.67, CI; 1.50-4.76, <i>P</i> = 0.001) and preoperative endothelial folds (HR; 2.82, CI; 1.20-6.62, <i>P</i> = 0.02). The incidence of graft endothelial failure in non-FECD patients was significantly higher among those receiving donor grafts with a pseudophakic lens status and preoperative presence of endothelial folds (<i>P</i> < 0.001). Postoperative ECD loss was significantly greater in eyes with these risk factors compared to those without (<i>P</i> = 0.007).<h4>Conclusions</h4>Pseudophakic status and/or presence of preoperative endothelial folds are the significant donor risk factors for endothelial failure in non-FECD patients.Frontiers in medicine810536https://www.ebi.ac.uk/biostudies/studies/S-EPMC8889573biostudies-literatureDonor-Related Risk Factors for Graft Decompensation Following Descemet's Stripping Automated Endothelial Keratoplasty.PMC8889573Higa KNishisako SNoma HShimazaki JYamaguchi THirayama MAoki DSasaki CfalseDonor-Related Risk Factors for Graft Decompensation Following Descemet's Stripping Automated Endothelial Keratoplasty.<h4>Aims</h4>To identify donor-related risk factors associated with graft endothelial failure and postoperative endothelial cell density (ECD) reduction after Descemet's stripping automated endothelial keratoplasty (DSAEK).<h4>Methods</h4>This was a single-center retrospective study conducted from July 2006-December 2016. We included 584 consecutive eyes (482 patients) that underwent DSAEK for the treatment of laser iridotomy-related bullous keratopathy (192 eyes), pseudophakic bullous keratopathy (137 eyes), regraft (96 eyes), Fuchs' endothelial corneal dystrophy (FECD; 59 eyes) and others (100 eyes). Twenty-three donor- and recipient-related risk factors potentially associated with graft failure and ECD reduction were assessed using Cox hazard models and linear mixed effect models.<h4>Results</h4>The median age of the patients was 73.5 years (male; 35.6%). After DSAEK, ECD decreased from 2,674 cells/mm² (95% confidence interval [CI]; 2,646-2,701) to 1,132 (1,076-1,190) at 12 months and 904 (845-963) at 24 months (<i>P</i> < 0.001). Fifty-five eyes (9.4%) had graft endothelial failure without rejection. This failure was associated with donor pseudophakic lens status (hazard ratio [HR]; 2.67, CI; 1.50-4.76, <i>P</i> = 0.001) and preoperative endothelial folds (HR; 2.82, CI; 1.20-6.62, <i>P</i> = 0.02). The incidence of graft endothelial failure in non-FECD patients was significantly higher among those receiving donor grafts with a pseudophakic lens status and preoperative presence of endothelial folds (<i>P</i> < 0.001). Postoperative ECD loss was significantly greater in eyes with these risk factors compared to those without (<i>P</i> = 0.007).<h4>Conclusions</h4>Pseudophakic status and/or presence of preoperative endothelial folds are the significant donor risk factors for endothelial failure in non-FECD patients.2022-01-01T00:00:00Z20222024-11-12T06:26:48.824Z2024-11-12T06:26:48.824ZS-EPMC88895733525224910.3389/fmed.2022.810536