Cornea donor characteristics less important than recipient’s
CHICAGO – The Eye Bank Association of America’s minimum standards for cornea tissue yields reliable results with donor characteristics mattering less than recipient characteristics, according to a speaker here.
Studies have shown donor age is not associated with graft rejection and that time from death to preservation or surgery is not associated with changes in endothelial cell density over time, Marian Sue Macsai -Kaplan, MD, explained at Cornea Subspecialty Day preceding the American Academy of Ophthalmology annual meeting.
“In addition, we’ve learned that preservation time of the tissue up to 11 days had no impact on 3-year outcomes,” she said. “Numerous other donor factors were non-contributory and recipients under 51 have an increased risk of rejection. It has nothing to do with the donor, it all has to do with the recipient.”
The Cornea Preservation Time Study did find tissue from diabetic donors had an early graft failure rate 2 times higher; however, early graft failure was 4 times higher with surgical complications such as corneal edema from cataract surgery.
“When asked about your graft requirements by the eye bank, nothing really matters...It’s your prerogative, it’s your technique,” Macsai-Kaplan said.
In addition, Macsai-Kaplan highlighted the importance of the eye bank in preparing donor tissue as cornea transplant surgery becomes more popular.
Having the eye bank cut and strip the tissue, preload the cornea, stamp it with an S-stamp and transport it to surgeons is both safe and efficacious, she said.
“We have learned from many studies that it is safe for the eye bank to cut your tissue. Why would you take the risk of failure or stripping or cutting when your eye bank does this day in, day out?” she asked. “These techniques have been validated in their safety in the eye bank, in transportation and in efficacy in the patient.” – by Rebecca L. Forand
Reference: Macsai-Kaplan M. Do corneas grow on trees? The evolving role of eye banks. Presented at: AAO Subspecialty Day, Oct. 26-27, 2018; Chicago.
Disclosure: Macsai-Kaplan reports no relevant financial disclosures.