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Author Notes:

Mark J. Mannis, M.D., c/o CDS Coordinating Center, Jaeb Center for Health Research, 15310 Amberly Drive, Suite 350, Tampa, FL 33647, Phone: (813) 975-8690; Fax: (813) 975-8761; cds@jaeb.org.

Edward J. Holland, MD is employed by the Cincinnati Eye Bank, and serves as a consultant and receives lecture fees from Bausch & Lomb; Irving M. Raber, MD receives lecture fees from Bausch & Lomb; Robert L. Schultze, MD is employed by Sight Society of Northeastern New York and receives lecture fees from Bausch & Lomb; Monty M. Montoya, MBA is employed by SightLife; Jeffrey G. Penta, MBA is employed by San Diego Eye Bank.


Research Funding:

Supported by cooperative agreements with the National Eye Institute, National Institutes of Health, Department of Health and Human Services EY12728 and EY12358.

Additional support provided by: Eye Bank Association of America; Bausch & Lomb, Inc.; Tissue Banks International; Vision Share, Inc.; San Diego Eye Bank; The Cornea Society; Katena Products, Inc.; ViroMed Laboratories, Inc.; Midwest Eye-Banks (Michigan Eye-Bank, Illinois Eye-Bank, Cleveland Eye Bank and Lions Eye Bank of New Jersey); Konan Medical Corp.; Eye Bank for Sight Restoration; SightLife; Sight Society of Northeastern New York (Lions Eye Bank of Albany); Lions Eye Bank of Oregon.


  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aging
  • Child
  • Corneal Edema
  • Double-Blind Method
  • Eye Banks
  • Female
  • Follow-Up Studies
  • Fuchs' Endothelial Dystrophy
  • Graft Survival
  • Humans
  • Keratoplasty, Penetrating
  • Male
  • Middle Aged
  • Prospective Studies
  • Registries
  • Tissue Donors
  • Young Adult

The effect of donor age on penetrating keratoplasty for endothelial disease: Graft survival after 10 years in the cornea donor study

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Journal Title:

Ophthalmology (Section 12 EMBASE)


Volume 120, Number 12


, Pages 2419-2427

Type of Work:

Article | Post-print: After Peer Review


Objective: To determine whether the 10-year success rate of penetrating keratoplasty for corneal endothelial disorders is associated with donor age. Design: Multicenter, prospective, double-masked clinical trial. Participants A total of 1090 participants undergoing penetrating keratoplasty at 80 sites for Fuchs' dystrophy (62%), pseudophakic/aphakic corneal edema (34%), or another corneal endothelial disorder (4%) and followed for up to 12 years. Methods: Forty-three eye banks provided corneas from donors aged 12 to 75 years, using a randomized approach to assign donor corneas to study participants without respect to recipient factors. Surgery and postoperative care were performed according to the surgeons' usual routines. Main Outcome Measures:Graft failure defined as a regraft or, in the absence of a regraft, a cloudy cornea that was sufficiently opaque to compromise vision for 3 consecutive months. Results: In the primary analysis, the 10-year success rate was 77% for 707 corneas from donors aged 12 to 65 years compared with 71% for 383 donors aged 66 to 75 years (difference, +6%; 95% confidence interval, -1 to +12; P = 0.11). When analyzed as a continuous variable, higher donor age was associated with lower graft success beyond the first 5 years (P < 0.001). Exploring this association further, we observed that the 10-year success rate was relatively constant for donors aged 34 to 71 years (75%). The success rate was higher for 80 donors aged 12 to 33 years (96%) and lower for 130 donors aged 72 to 75 years (62%). The relative decrease in the success rate with donor ages 72 to 75 years was not observed until after year 6. Conclusions: Although the primary analysis did not show a significant difference in 10-year success rates comparing donor ages 12 to 65 years and 66 to 75 years, there was evidence of a donor age effect at the extremes of the age range. Because we observed a fairly constant 10-year success rate for donors aged 34 to 71 years, which account for approximately 75% of corneas in the United States available for transplant, the Cornea Donor Study results indicate that donor age is not an important factor in most penetrating keratoplasties for endothelial disease. Financial Disclosure(s) Proprietary or commercial disclosure may be found after the references.

Copyright information:

© 2013 by the American Academy of Ophthalmology Published by Elsevier Inc.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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