Impact Of Recipient And Donor Factors On Corneal Graft Clearance: Insights From Serial Anterior Segment Optical Coherence Tomography Imaging

Published 2025 - 43rd Congress of the ESCRS

Reference: PO533 | Type: Free paper | DOI: 10.82333/5e2w-qh76

Authors: Andrés Germán Alza* ¹

¹Ophtalmology,Clínica Privada de Ojos Dr. Enrique Alza,La Plata,Argentina

Purpose

To assess the impact of pre-operative recipient and donor-related factors on the rate of corneal graft clearance using serial Anterior Segment Optical Coherence Tomography (AS-OCT) imaging.

Setting

This prospective cohort study was conducted at the Ophthalmology Clinic of Archbishop Makarios III Hospital, State Health Services Organization, Nicosia, Cyprus, in collaboration with the University of Cyprus Medical School. Seventy-one patients (76 eyes) who underwent corneal transplantation (PKP, DSAEK, or DMEK) between October 2021 and April 2024 were included, with a minimum follow-up of 6 months.

Methods

Serial AS-OCT pachymetry maps and cross-sectional scans were performed at fixed post-operative intervals. Mixed linear regression models with time-splines were used to assess changes in recipient central corneal and graft thickness over time. Adjusted regression coefficients (β) and standard errors (SE) were calculated.

Results

The mean recipient age was 73.8 ± 12.0 years and the mean donor age 54 ± 15.9 years. CCT and CGT decreased significantly up to 3 months (CCT: β = -1.73, p < 0.001; CGT: β = -0.53, p < 0.001) before stabilizing (CCT: β = 0.063, p = 0.156; CGT: β = 0.02, p = 0.228). Younger donor age (<56 years) was linked to faster clearance (β = 0.67, p = 0.004). PKP had a slower CCT decrease than DSAEK (β = 0.74, p = 0.021). Higher donor ECD (≥3,021 cells/mm²) was associated with faster clearance (β = -1.14, p = 0.001). Postoperative CCT and CGT remained stable beyond 3 months. Graft clearance was unaffected by recipient gender, pre-op CCT, diagnosis, donor diabetes, or preservation-related times (death-to-preservation, death-to-surgery, cut-to-surgery).

Conclusions

This study underscores the critical role of donor-related factors, including age, and ECD in achieving faster corneal and graft clearance. The findings highlight the importance of targeted donor selection and early post-operative management to optimize outcomes. The use of serial AS-OCT imaging demonstrates its value as a non-invasive tool for monitoring and assessing graft dynamics, with significant potential for improving clinical practice and guiding future research.