Effect of donor graft quality on clinical outcomes after penetrating keratoplasty for keratoconus

Purpose: to evaluate the effect of donor and eye bank characteristics on graft rating and clinical outcomes after penetrating keratoplasty (pk) for keratoconus. methods: this retrospective interventional case series included 252 keratoconic eyes which underwent pk. donor data included age and sex,cause of death,death-to-preservation time,preservation-to-surgery time,epithelial and stromal status,endothelial cell density (ecd) and morphology,and graft rating. postoperative outcomes included visual acuity,refractive error,epithelial problems,suture-related complications,graft rejection,and graft transparency. multivariate regression analysis assessed correlations between donor and eye bank characteristics and graft quality,and postoperative outcomes. results: mean recipient and donor age was 29.7 ± 10.0 and 26.2 ± 8.8 years,respectively and mean follow-up period was 66.7 ± 38.5 months. death-to-preservation time was significantly associated with the presence of graft epithelial sloughing (p = 0.005) and stromal cloudiness (p < 0.001). donor age significantly influenced ecd (p = 0.02),mean cell area (p = 0.04),and hexagonality (p = 0.01). the presence of epithelial defects on postoperative day 1 correlated significantly with death-to-preservation time (p = 0.004). graft stromal edema on postoperative day 1 was significantly associated with graft epithelial sloughing (p < 0.001). postoperative visual and refractive outcomes,complications,and graft survival were not correlated with any donor or eye bank factors. conclusion: donor and eye bank variables affected the quality of donor corneas and early postoperative course. however,their long term effect on clinical outcomes,complications,and graft survival were insignificant. © 2015 journal of ophthalmic and vision research | published by wolters kluwer - medknow.