• Cornea/External Disease

    Review of: Gender Matching Did Not Affect 2-year Rejection or Failure Rates Following DSAEK for Fuchs Endothelial Corneal Dystrophy

    Romano V, Parekh M, Virgili G, et al. American Journal of Ophthalmology, March 2022

    Patients with Fuchs dystrophy who received gender or H-Y matched donor corneas showed no difference in graft failure or rejection compared with those who received mismatched donor corneas.

    Study design

    This was a cohort study using a multicenter registry. Inclusion criteria were adults greater than or equal to 18 years of age who had undergone a primary Descemet stripping automated endothelial keratoplasty (DSAEK) for Fuchs dystrophy between January 2008 and March 2018. The primary outcomes were graft rejection and failure up to 2 years after DSAEK.


    Data from 4341 eyes were collected and analyzed. Mean patient age was 71.9 years. At the 2 year follow-up, graft rejection occurred in 4% of cases, and graft failure in 11% of eyes. The authors found no significant relationship between gender or H-Y mismatching and rejection or failure.


    One limitation of this investigation was the lack of information regarding the HLA type of donors.

    Clinical significance

    Gender and H-Y mismatching were previously shown to be associated with graft failure in eyes that had been treated with penetrating keratoplasty (PK). However, unlike with PK, selection of donor corneas for DSAEK with gender and H-Y matching may not provide improved outcomes.