Impact of Donor Age on Descemet Membrane Endothelial Keratoplasty Outcome: Evaluation of Donors Aged 17-55 Years.

Abstract

To investigate whether the impression held by Descemet membrane endothelial keratoplasty (DMEK) surgeons that young donors are less suitable for DMEK is reflected in 1-year postoperative results. Retrospective, comparative, interventional case series. Records of 1084 consecutive DMEKs were reviewed and matched with corresponding donor tissue data. Young donors (aged ≤55 years; subgroups: 10-40, 41-55) were compared with old donors (>55 years; subgroups: 56-65, >65). Outcome measures in DMEK recipients included best spectacle-corrected visual acuity (BSCVA), endothelial cell density (ECD), central corneal thickness (CCT) at 6 and 12 months, and rebubbling rate. Out of 529 included DMEKs, 94 (17.8%) were performed with young donor lamellae (mean donor age 49.31 ± 6.35 years; range: 17-55 years) and 435 (82.2%) with older donor tissue (mean age 70.68 ± 7.77 years; range: 56-90 years). Postoperative BSCVA, ECD, and CCT results were comparable in both groups at 6 and 12 months without statistically significant differences. Overall rebubbling rate in the young donor group was 42.6% and in the old donors was 53.3% (P = .058). Complication rates also did not differ significantly. Younger donor age seems not to affect the clinical outcome of DMEK surgery negatively within the first postoperative year, suggesting donor corneas with donor age down to 17 years as safe donor tissue for DMEK surgery.