Evaluating the effect of donor and recipient factors on graft survival after penetrating keratoplasty

Abstract

Corneal diseases are one of the leading causes of visual loss and blindness, after cataracts and glaucoma across the globe. Management of corneal blindness requires corneal transplantation which is dependent on voluntary corneal donations and needs tremendous post-operative care and follow-up. The success of the procedure depends upon various donor and recipient factors that need to be studied.A prospective study was conducted in the eye bank of the tertiary care eye center in central India after getting the approval of the institutional ethical committee. A total of 26 eyes of 13 donors were studied, out of which 23 eyes underwent penetrating keratoplasty, among these, 3 eyes underwent therapeutic penetrating keratoplasty, 16 eyes underwent optical penetrating keratoplasty and 4 eyes underwent triple procedures. Recipients were followed up at 1 week, 1 month, and 3rd months, and data were analyzed.Graft survival was significantly better in the recipients without pre-operative corneal vascularization (p=0.004). Corneas from a donor with open eyelids showed significantly poor graft survival. This was statistically significant (p= 0.047). On the other hand, based on donor lens status, we did not find any difference in the survival of the graft. Practices like lid closure and eye drop installation should be promoted from the time of death, for preserving donor tissue quality. HCRP should be promoted and practiced at the national level as it is effective in increasing the rate of eye donation and positively affects graft outcomes.