Suitability of Corneal Tissue Related to Donor Ophthalmic History

Purpose: Corneas from donors with posterior ocular pathologies are routinely procured for corneal transplantation. However, posterior ocular diseases including glaucoma, diabetic retinopathy (DR) and age-related macular degeneration (AMD) and their influence on corneal suitability have not been well studied. Corneal suitability, or percentage of corneal tissues eligible for transplant after procurement, is monitored by eye banks. Different factors such as corneal pathologies, endothelial cell density and previous ocular surgeries are known to directly impact corneal suitability. We performed a two year retrospective study to evaluate corneal suitability and the relationship to posterior ophthalmic pathologies. Methods: The Eversight electronic medical record system was mined to acquire ophthalmic history and corneal suitability for all surgical donors procured between January 1, 2016 and December 31, 2017. Corneal suitability was calculated for corneas with and without posterior ocular pathologies using a univariate logistic regression model. Average reimbursement rates per cornea between these groups were compared. Results: Of the 24,884 total corneas evaluated, 71.1% (n= 17,693) were deemed suitable. Of those corneas, glaucomatous corneas (n=641) were found to have a suitability rate of 64.6% (n=414, p= 0.0002). Donors with DR (n=343) and AMD (n=181) had an average suitability rate of 74.9% (p=0.12) and 69.1% (p=0.53) respectively. The average reimbursement for transplanted corneas from non-glaucoma donors was $2,435.56 compared to $2,156.57 for glaucomatous donors. Corneas from non-DR donors had an average reimbursement of $2,430.65 vs $2,296.41 DR donors. Corneas from non-AMD donors had an average reimbursement of $2,428.89 vs $2,405.95 for AMD donors. Conclusions: Eyes with a history of glaucoma have a statistically significant decreased in corneal suitability when compared with all cornea donors. Transplanted corneas from donors with glaucoma, DR and AMD all had lower reimbursement averages compared to non-effected donors. The clinical significance of these findings is unclear, although it may help eye banks in the donor screening and placement processes. Currently, there is a shortage of posterior ocular diseased tissue available for research. Instead of procuring these donors surgically, donors with posterior ocular pathologies could be procured for research-subsequently alleviating the shortage of diseased tissue