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Speaker calls for prospective studies of donor diabetes and keratoplasty outcomes
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LAS VEGAS — Because the effect of donor diabetes history on keratoplasty outcomes is unknown, there is a need for prospective studies to manage its impact, according to a presentation here.
Jonathan Lass, MD, discussed the growing problem of the impact of donor diabetes on the future of the cornea donor pool and patients requiring keratoplasty at the American Academy of Ophthalmology annual meeting.
“There is no long-term prospective data on penetrating keratoplasty or endothelial keratoplasty (EK) success and cell loss with diabetic donors,” he said. “Most diabetic donors are fine, but could there be a subset of diabetic donors that we should not be using for DMEK preps, or PK or EK in general?”
In addition to limited data, Lass said that the expanding donor pool, lack of diabetes characterization in donors and DMEK prep failures also contribute to the problem.
He recommends a randomized, multicenter masked clinical trial with donor assignments based on diabetic donor status be performed. Lass said donors should be well-characterized with regard to their diabetes status and recipient diabetes status should be accounted for.
“The study should examine graft success and cell loss for 3 to 5 years postoperatively using EK because of the volume of cases,” Lass said. “This addresses both the prep issue and long-term performance.” — by Kristie L. Kahl
Reference:
Lass J. Donor diabetes history and keratoplasty outcomes. Presented at: American Academy of Ophthalmology annual meeting. Nov. 14, 2015; Las Vegas.
Disclosure: Lass reports he is a speaker for Aerie Pharmaceutical, Bausch + Lomb, Eyetech, Icon Bioscience, InnFocus, Ivantis, National Eye Institute, ORA, Presbia, Reata Pharmaceuticals, Regeneron Pharmaceuticals, Transcend Medical and Trial Runners.