Influence of Various Donor-Related Factors on Ultimate Graft Survival Following Penetrating Keratoplasty

Abstract

BACKGROUNDThis prospective study was undertaken to evaluate various donor factors affecting the corneal graft survival to stress on maximum and best utilisation of donor material without compromising the graft outcome.The aim of this article is to study and correlate effects of corneal morbidity status of deceased and its effect on donor corneas, correlation between time of death and enucleation in relation to time of day, season of the year and influence of various environmental and climatic factors on donor cornea. MATERIALS AND METHODSAll surgeries were performed by single experienced anterior segment surgeon. Donor age, cause of death, duration of illness, time of death and time interval between death to enucleation (preservation) time were recorded. Time of the day (morning, afternoon and night) and Season of the year (summer, winter, rainy) along with Place of death (at home/ hospital/ road traffic accident) of donor was studied in relation to corneal graft survival. Only uncomplicated cases of corneal opacity and pseudophakic bullous keratopathy for penetrating keratoplasty were included in the study group. Statistical Analysis-Chi-square test of significance was applied. Setting and Study Design-This is a prospective observational study conducted in a tertiary care hospital in Maharashtra. RESULTIn a series of 40 penetrating keratoplasty performed during 24 months' time period, the overall percentage of clear graft was 55.26% at a mean 24 months followup. The survival of the graft did not differ significantly with donor age, (X 2 = 3.172, P= 0.204). However, more number of grafts from males survived as compared to those from females in our study, (X 2 = 9.025, P= .002). Survival of donor graft was not statistically significant for different death to enucleation time, (X 2 =0.5, P=0.90). Two patients were lost for followup. CONCLUSIONCorneas should not be refused for surgery if they satisfy tissue acceptance criteria for optical purpose when corneas are retrieved from aged donors, procured from hospitals/ refrigerated bodies despite prolonged death to enucleation time.