Skip to main content
SpringerLink
Log in

Proposed risk factors for failure of transplanted eye bank-prepared descemet stripping automated endothelial keratoplasty tissues

  • Full Length Paper
  • Published:
Cell and Tissue Banking Aims and scope Submit manuscript

Abstract

To investigate the possible risk factors for failure of transplanted eye bank-prepared Descemet stripping automated endothelial keratoplasty (DSAEK) tissues. In a retrospective study between March 2011 and March 2019, all the failed DSAEK cases (131 cases) reported to the Central Eye Bank of Iran were compared with a surgeon-matched successful DSAEK group (control, 126 cases) in terms of the donor, DSAEK tissue, and recipient characteristics. Univariate analysis indicated that the DSAEK tissue preparation from excised corneoscleral tissues (OR 2.17; P = 0.026) and donor conjunctival hyperemia (OR 1.62; P = 0.042) were more common in the re-DSAEK group than in the controls. Other donor and recipient characteristics as well as other DSAEK tissue criteria were not significantly different between the re-DSAEK and control groups. DSAEK lenticules in both re-DSAEK and control groups demonstrated symmetric contours. Subgroup analyses in the re-DSAEK group revealed a higher rate of surgeons’ low to moderate experience in comparison to those of high experience (P < 0.001). Additionally, failed DSAEK was observed more commonly in donors aged over 50 years than among those under 30 years (P < 0.001). Our study showed that DSAEK tissues prepared from excised corneoscleral tissues and from donors with conjunctival hyperemia were associated with higher rates of re-DSAEK due to failed DSAEK. An increasing trend of re-DSAEK was observed with shorter surgeons’ experience and more advanced donor’s age.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Ang M, Soh Y, Htoon HM, Mehta JS, Tan D (2016) Five-Year graft survival comparing Descemet stripping automated endothelial keratoplasty and penetrating keratoplasty. Ophthalmology 123:1646–1652

    Article  Google Scholar 

  • Bailey LA, Groenendaal EA, Florakis EM, Florakis GJ (2014) Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK): dislocation and failure rates-one surgeon’s first 245 cases. Invest Ophthalmol Vis Sci 55(13):886

    Google Scholar 

  • Cornea Donor Study Group (2013) The effect of donor age on penetrating keratoplasty survival after 10 years in the Cornea Donor Study. Ophthalmology 120:2419–2427

    Article  Google Scholar 

  • Cunningham WJ, Brookes NH, Twohill HC, Moffatt SL, Pendergrast DG, Stewart JM, McGhee CN (2012) Trends in the distribution of donor corneal tissue and indications for corneal transplantation: the New Zealand national eye bank study 2000–2009. Clin Exp Ophthalmol 40:141–147

    Article  Google Scholar 

  • Dobbins KR, Price FW Jr, Whitson WE (2000) Trends in the indications for penetrating keratoplasty in the midwestern United States. Cornea 19:813–816

    Article  CAS  Google Scholar 

  • Frigo AC, Fasolo A, Capuzzo C, Fornea M, Bellucci R, Busin M, Marchini G, Pedrotti E, Ponzin D, CORTES Study Group (2015) Corneal transplantation activity over 7 years: changing trends for indications, patient demographics and surgical techniques from the Corneal Transplant Epidemiological Study (CORTES). Trans Proc 47:528–535

    Article  CAS  Google Scholar 

  • Kanavi MR, Javadi MA, Javadi F, Chamani T (2014) Preparation of pre-cut corneas from fresh donated whole globes for Descemet’s stripping automated keratoplasty: 3-year results at the Central Eye Bank of Iran. Cell Tissue Bank 15(3):369–372

    Article  Google Scholar 

  • Kanavi MR, Chamani T, Kheiri B, Javadi MA (2018) Single versus double pass technique for preparation of ultrathin Descemet’s stripping automated endothelial keratoplasty tissues from donated whole eyes. Cell Tissue Bank 19(4):623–628

    Article  Google Scholar 

  • Koenig SB, Covert DJ (2007) Early results of small-incision Descemet’s stripping and automated endothelial keratoplasty. Ophthalmology 114(2):221–226

    Article  Google Scholar 

  • Lass JH, Benetz BA, Verdier DD, Szczotka-Flynn LB, Ayala AR, Liang W, Aldave AJ, Dunn SP, McCall T, Mian SI, Navarro LC, Patel SV, Pramanik S, Rosenwasser GO, Ross KW, Terry MA, Kollman C, Gal RL, Beck RW, Cornea Preservation Time Study Group (2017) Corneal endothelial cell loss 3 years after successful descemet stripping automated endothelial keratoplasty in the cornea preservation time study: a randomized clinical trial. JAMA Ophthalmol 135(12):1394–1400

    Article  Google Scholar 

  • Le R, Yucel N, Khattak S, Yucel YH, Prud’homme GJ, Gupta N (2017) Current indications and surgical approaches to corneal transplants at the University of Toronto: a clinical-pathological study. Can J Ophthalmol 52(1):74–79

    Article  Google Scholar 

  • Letko E, Price DA, Lindoso EM, Price MO, Price FW Jr (2011) Secondary graft failure and repeat endothelial keratoplasty after Descemet’s stripping automated endothelial keratoplasty. Ophthalmology 118(2):310–314

    Article  Google Scholar 

  • Ple-Plakon PA, Shtein RM (2014) Trends in corneal transplantation: indications and techniques. Curr Opin Ophthalmol 25:300–305

    Article  Google Scholar 

  • Price MO, Price FW Jr (2006) Descemet’s stripping with endothelial keratoplasty: comparative outcomes with microkeratome dissected and manually dissected donor tissue. Ophthalmology 113:1936–1942

    Article  Google Scholar 

  • Qazi Y, Hamrah P (2013) Corneal allograft rejection: immunopathogenesis to therapeutics. J Clin Cell Immunol. https://doi.org/10.4172/2155-9899.s9-006

    Article  PubMed  PubMed Central  Google Scholar 

  • Rezaei Kanavi M, Javadi MA, Motevasseli T, Chamani T, Rezaei Kanavi M, Kheiri B, Safi S (2016) Trends in Indications and techniques of corneal transplantation in Iran from 2006 to 2013; an 8-year review. J Ophthalmic Vis Res 11(2):146–152

    Article  Google Scholar 

  • Rezaei Kanavi M, Javadi MA, Safi S, Moshtaghion MM, Abolhosseini M (2018) A 3-decade activity of the Central Eye Bank of Iran. Bina J Ophthalmol 24(2):105–115

    Google Scholar 

  • Rosenwasser GO, Szczotka-Flynn LB, Ayala AR, Liang W, Aldave AJ, Dunn SP, McCall T, Navarro LC, Pramanik S, Ross KW, Stulting RD, Terry MA, Tu EY, Verdier DD, Kollman C, Gal RL, Beck RW, Lass JH, Cornea Preservation Time Study Group (2017) Effect of cornea preservation time on success of descemet stripping automated endothelial keratoplasty: a randomized clinical trial. JAMA Ophthalmol 135(12):1401–1409

    Article  Google Scholar 

  • Tan JC, Holland SP, Dubord PJ, Moloney G, McCarthy M, Yeung SN (2014) Evolving indications for and trends in keratoplasty in British Columbia, Canada, from 2002 to 2011: a 10-year review. Cornea 33:252–256

    Article  Google Scholar 

  • Terry MA (2007) Endothelial keratoplasty: clinical outcomes in the two years following deep lamellar endothelial keratoplasty. Trans Am Ophthalmol Soc 105:1–34

    Google Scholar 

  • Terry MA, Aldave AJ, Szczotka-Flynn LB, Liang W, Ayala AR, Maguire MG, Croasdale C, Daoud YJ, Dunn SP, Hoover CK, Macsai MS, Mauger TF, Pramanik S, Rosenwasser GOD, Rose-Nussbaumer J, Stulting RD, Sugar A, Tu EY, Verdier DD, Yoo SH, Lass JH, Cornea Preservation Time Study Group (2018) Donor, recipient, and operative factors associated with graft success in the cornea preservation time study. Ophthalmology 125(11):1700–1709

    Article  Google Scholar 

  • Wang JY, Xie LX, Song XS, Zhao J (2011) Trends in the indications for penetrating keratoplasty in Shandong, 2005–2010. Int J Ophthalmol 4:492–497

    PubMed  PubMed Central  Google Scholar 

  • Williams KA, Esterman AJ, Bartlett C, Holland H, Hornsby NB, Coster DJ (2006) How effective is penetrating corneal transplantation? Factors influencing long-term outcome in multivariate analysis. Transplantation 81:896–901

    Article  Google Scholar 

  • Williams KA, Lowe M, Bartlett C, Kelly TL, Coster DJ, Contributors All (2008) Risk factors for human corneal graft failure within the Australian corneal graft registry. Transplantation 86:1720–1724

    Article  Google Scholar 

  • Woodward MA, Titus M, Mavin K, Shtein RM (2012) Corneal donor tissue preparation for endothelial keratoplasty. J Vis Exp 64:e3847

    Google Scholar 

  • Writing Committee for the Cornea Donor Study Research Group, Lass JH, Benetz BA, Gal RL, Kollman C, Raghinaru D, Dontchev M, Mannis MJ, Holland EJ, Chow C, McCoy K, Price FW Jr, Sugar A, Verdier DD, Beck RW (2013) Donor age and factors related to endothelial cell loss 10 years after penetrating keratoplasty: specular Microscopy Ancillary Study. Ophthalmology 120(12):2428–2435

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Ocular Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, No 23, Paydarfard-9th Boostan St., Pasdaran Ave, Tehran, 1666673111, Iran

    Mozhgan Rezaei Kanavi

  2. Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Mohammad Ali Javadi & Bahareh Kheiri

  3. Central Eye Bank of Iran, Tehran, Iran

    Mohammad Ali Javadi, Tahereh Chamani, Mohsen Rahmanian & Mahnoush Rezaei Kanavi

Authors
  1. Mozhgan Rezaei Kanavi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mohammad Ali Javadi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tahereh Chamani
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mohsen Rahmanian
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mahnoush Rezaei Kanavi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Bahareh Kheiri
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mozhgan Rezaei Kanavi.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

For reviewing the donors’ and patients’ records, full ethical authorization was obtained from the Institutional Review Board of the Central Eye Bank of Iran and the ethics committee of the Ophthalmic Research Center at the Shahid Beheshti University of Medical Sciences, Tehran-Iran.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kanavi, M.R., Javadi, M.A., Chamani, T. et al. Proposed risk factors for failure of transplanted eye bank-prepared descemet stripping automated endothelial keratoplasty tissues. Cell Tissue Bank 21, 151–158 (2020). https://doi.org/10.1007/s10561-020-09808-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10561-020-09808-5

Keywords

Search

Navigation