Risk factors for endothelial loss in DSAEK graft pre-cutting

This prospective study identified risk factors for endothelial cell loss during pre-cutting of DSAEK grafts, including older donor age and slower cutting transition speed.  

The authors write that because DSAEK has evolved to be the most frequently performed keratoplasty procedure and the use of precut tissue is becoming increasingly popular, it is important to know which factors are associated with greater endothelial cell density loss in pre-cutting procedures.

They analyzed tissue from 259 corneoscleral rims pre-cut for DSAEK procedures by the Singapore Eye Bank from October 2011 to August 2013.

The mean endothelial cell loss was quite low at 1.38%. Older donor age, higher endothelial cell density before precutting, and a slower cutting transition speed were significantly associated with greater endothelial cell loss after precutting.

Donor source, death-to-preservation time (range, 0.67 to 10.88 hours), death-to-pre-cutting time (range, 0 to 7 days) and graft thickness (range, 43 to 232 mm) were not statistically significant factors.

They conclude that the risk factors identified provide a better understanding of how to improve the quality and safety profiles when preparing graft tissue for DSAEK.