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The effect of cornea preservation time on DMEK outcomes

Poster Details

First Author: M.Montpetit Gonzalez SPAIN

Co Author(s):    J. Choremis   M. Mabon   T. Boutin   I. Brunette   J. Talajic        

Abstract Details


The average preservation time (PT) in the USA is usually fewer than 8 days, as many surgeons reject donor tissue that has been stored for longer. In contrast, donor corneas in our Canadian hospital are frequently used beyond this date, as our mean PT is 7.8 days. Therefore, our overall goal is to assess if a longer graft storage time has an impact on the outcome of DMEK transplants.


Centre Universitaire Ophtalmologique, Maisonneuve-Rosemont Hospital (HMR), University of Montreal, Montreal (Quebec), Canada.


This is a retrospective cohort study. 339 consecutive cases of DMEK performed at our hospital between March 2015 and December 2018 were reviewed. Only cases that met all inclusion criteria (Fuchs endothelial cell dystrophy and no previous glaucoma or retina surgery) were enrolled. A total of 289 DMEK performed on 215 patients were analyzed according to their cornea PT. The primary outcome was corneal endothelial cell density (ECD) at 12 months post­DMEK, and secondary outcome parameters were ECD at 6 and 24 months, graft failure and rebubbling rates.


Mean (±SD) age at surgery was 70 (±9.0) years (range:40­-93 years), 62.3% were women). Mean preoperative donor ECD was 2738.9 (±273.2) cells/mm2. Mean PT was 7.8(±1.8) days (range:2.5-13.1). At 12-months, mean ECD decreased to 1180(±457) cells/mm2, which represented a mean cell loss of 56.7% (±16.2%). ANOVA detected a mild effect of PT over ECD (F (1,164) =5.5; p=0.0204). A reduction of 57.2 cells/mm2 was observed for each additional day of graft preservation [95% CI: 9 to 105]. Mean rebubbling and failure rates were 21.7% and 10.6%, respectively. No effect of PT over these outcomes was observed (p=0.59 and p=0.81, respectively).


In this study, longer graft preservation time was associated with decreased ECD. This is thought to reduce graft survival in the long term. While the effect was relatively small, it was statistically significant. This may incite eye banks to seek ways to reduce tissue preservation time. To confirm these findings, a larger sample size of donor tissue with longer PT is needed.

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