Donor age associated with corneal button graft opacification

GUADALAJARA, Mexico — Most corneal opacities that develop following penetrating keratoplasty relate to the age of the donor and a preoperative diagnosis of leukoma, according to a poster study presented here.

Narlly del Carmen Ruiz Quintero, MD, and colleagues analyzed data for 431 grafts in 406 keratoplasty patients treated from 1998 to 2000 at Mexico’s Hospital for the Association for the Avoidance of Blindness. The researchers sought to understand how tissue from donors age 50 years and older functions following transplant.

“With the advent of refractive surgery, there are fewer young donor corneas that can be used. For this reason, it is important to establish if corneal buttons of elderly donors are usable and how much they determine the final prognosis of a corneal graft,” the researchers said in the study.

Patients included in the study had a mean age of 41 years and were followed for a minimum of 5 years postop. All corneal buttons used during surgery contained at least 2,000 endothelial cells, according to the study.

The researchers found that most graft rejections occurred with buttons from donors age 71 years or older. Specifically, 79 of 210 grafts from donors age 71 to 80 years old resulted in corneal opacities. Additionally, 23 of 79 grafts from donors age 81 to 89 years old resulted in opacities, while only 11 of 142 grafts from donors age 59 to 70 years old resulted in opacities.

A preoperative diagnosis of leukoma also correlated with graft rejection, the authors noted.

“We did not find a correlation between corneal button opacities and the experience of the surgeon,” they added.