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Descemet’s Stripping Automated Endothelial Keratoplasty Using Donor Tissue From Donors With a History of Laser In Situ Keratomileusis or Photorefractive Keratectomy
Jason Edmonds, MD
Wade McEntire, CEBT
Mark Mifflin, MD
DSAEK; LASIK; PRK; endothelial keratoplasty (EK)
Purpose: To identify prevalence of post refractive donor corneal tissue in the donor pool, utilization rate, and rate of complications compared to tissue from donors without previous refractive surgery.
Methods: We obtained data on prevalence and utilization of post-refractive cornea donor tissue from donor records at the Utah Lions Eye Bank (ULEB) from 2009-2012. Procurement and utilization rates of post-refractive donor tissue were compared to rates in the ULEB annual reports for non-refractive donor tissue. The incidence of primary graft failure in Descemet’s stripping automated endothelial keratoplasty (DSAEK) grafts and tissue loss during processing were analyzed.
Results: Between 2009 and 2012, 125 donor corneas were procured by the Utah Lions Eye Bank from donors that had undergone prior refractive surgery (i.e. laser in situ keratomileusis, LASIK, or photorefractive keratectomy, PRK). Of these 125 donor corneas, 45 were suitable for tectonic grafting only due to inadequate endothelial counts. Of the remaining 80 donor corneas intended for transplantation, 65 were used for DSAEK, 12 expired before utilization, 2 were rejected by the operating surgeon on the basis previous refractive surgery, and 1 cornea was damaged during preparation for DSAEK. One case of primary graft failure was reported. No other tissue related complications related to post refractive donor tissue were reported.
Conclusions: LASIK and PRK donor tissue appears to be safe and effective in DSAEK and would likely be acceptable for DMEK. Utilization of tissue from post refractive patients will increase in importance as this tissue becomes more prevalent in the donor pool.
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