Impact of the Cornea Preservation Time Study on Donor Cornea Preservation Time and Surgeon Attitudes

Authors

Sadeer B. Hannush, MD, Donna C. Drury, MBA, CEBT, Anthony J. Aldave, MD, Nathan J. Cohen, MS, Loretta B. Szczotka-Flynn, O.D., Ph.D., Allison R. Ayala, MS, Maureen G. Maguire Ph.D., Gregg J. Berdy, MD, W. Barry Lee, MD, Marian S. Macsai, MD, Eric E. Meinecke, CEBT, Shahzad I. Mian, MD, Michael L. Nordlund, MD, Ph.D., George O.D. Rosenwasser, MD, Kevin W. Ross, MS, MPH, Alan Sugar MD, Mark A. Terry, MD, Elmer Y. Tu, MD, Woodford S. Van Meter, MD, Jonathan H. Lass, MD, on behalf of the Cornea Preservation Time Study Group

Keywords

corneal endothelium, eye banking, preservation time

Abstract

Purpose: Assess the Cornea Preservation Time Study (CPTS)
impact on surgeon attitudes regarding preservation time (PT)
and eye-bank-reported PT for donors intended for endothelial
keratoplasty (EK).

Methods: Prior to CPTS recruitment (2012) and 6 months following
primary results publication (2017), American Academy
of Ophthalmology members with cornea interest were surveyed
regarding their PT attitudes for EK donors. Eye banks provided
PT data from 2010-2011, 2013-2014, and the first half of 2018
for all EK-intended donor corneas for domestic and international
distribution. Differences over time were assessed with chi-square
tests and logistic regression models for categorical responses,
and t-tests and linear regression assessed comparisons of mean
PT as reported by eye banks.

Results: 364 of 1,609 (22.6%) surgeons responded in 2012
and 297 of 1,872 (15.9%) in 2018. 98 surgeons (32%) in 2012
would accept donor corneas with PT >7 days compared to 122
(46%) in 2018 (p<0.001). Surgeons with >10 years’ experience
were likely to extend their PT limits to >7 days in 2018 vs 2012
(47% vs 28%, respectively, p<0.001). Eye-bank reported PT
increased from 4.6 days in 2010 (N=9317 donors) to 5.1 days
(N=7020 donors) in 2018, and donation year was significantly
associated with mean PT in a multivariable analysis (p<0.001).
Eye-bank reported PT >7 days increased from 3% in 2010 to 9%
in 2018.

Conclusions: The CPTS may influence surgeon-expressed attitudes
and eye bank reported PT, regarding acceptance of donor
tissue preserved > 7 days, supporting tissue safety and effectiveness
preserved up to 11 days for EK.