Jonathan H Lass1, Beth Ann Benetz2, Robin L Gal3, Craig Kollman3, Dan Raghinaru3, Mariya Dontchev3, Mark J Mannis4, Edward J Holland5, Christopher Chow6, Kristen McCoy7, Francis W Price8, Alan Sugar9, David D Verdier10, Roy W Beck3. 1. Case Western Reserve University and University Hospitals Eye Institute, Cleveland, Ohio. Electronic address: cds@jaeb.org. 2. Case Western Reserve University and University Hospitals Eye Institute, Cleveland, Ohio. 3. Jaeb Center for Health Research, Tampa, Florida. 4. University of California Davis, Sacramento, California. 5. Department of Ophthalmology and Visual Sciences, Cincinnati Eye Institute, Cincinnati, Ohio. 6. Michigan Cornea Consultants, P.C., Southfield, Michigan. 7. Illinois Eye Bank, Chicago, Illinois. 8. Price Vision Group, Indianapolis, Indiana. 9. W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan. 10. Verdier Eye Center, Grand Rapids, Michigan.
Abstract
OBJECTIVE: To examine the effect of donor age and other perioperative factors on long-term endothelial cell loss after penetrating keratoplasty (PKP). DESIGN: Multicenter, prospective, double-masked clinical trial. PARTICIPANTS: We included 176 participants from the Cornea Donor Study cohort who had not experienced graft failure ≥ 10 years after PKP for a moderate risk condition (principally Fuchs' dystrophy or pseudophakic/aphakic corneal edema). METHODS:Corneas from donors 12 to 75 years old were assigned to participants using a randomized approach, without respect to recipient factors. Surgery and postoperative care were performed according to the surgeons' usual routines. Images of the central endothelium were obtained preoperatively and at intervals for 10 years postoperatively. Images were analyzed by a central image analysis reading center to determine endothelial cell density (ECD). MAIN OUTCOME MEASURES: Endothelial cell density at 10 years. RESULTS: Among study participants with a clear graft at 10 years, the 125 who received a cornea from a donor 12 to 65 years old experienced a median cell loss of 76%, resulting in a 10-year median ECD of 628 cells/mm(2) (interquartile range [IQR], 522-850 cells/mm(2)), whereas the 51 who received a cornea from a donor 66 to 75 years old experienced a cell loss of 79%, resulting in a median 10-year ECD of 550 cells/mm(2) (IQR, 483-694 cells/mm(2); P adjusted for baseline ECD = 0.03). In addition to younger donor age, higher ECD values were significantly associated with higher baseline ECD (P<0.001) and larger donor tissue size (P<0.001). Forty-two of the 176 participants (24%) had an ECD of <500cells/mm(2) at 10 years and only 24 (14%) had an ECD of >1000 cells/mm(2). CONCLUSIONS: Substantial cell loss occurs in eyes with a clear graft 10 years after PKP, with the rate of cell loss being slightly greater with older donor age. Greater preoperative ECD and larger donor tissue size are associated with higher ECD at 10 years.
RCT Entities:
OBJECTIVE: To examine the effect of donor age and other perioperative factors on long-term endothelial cell loss after penetrating keratoplasty (PKP). DESIGN: Multicenter, prospective, double-masked clinical trial. PARTICIPANTS: We included 176 participants from the Cornea Donor Study cohort who had not experienced graft failure ≥ 10 years after PKP for a moderate risk condition (principally Fuchs' dystrophy or pseudophakic/aphakic corneal edema). METHODS: Corneas from donors 12 to 75 years old were assigned to participants using a randomized approach, without respect to recipient factors. Surgery and postoperative care were performed according to the surgeons' usual routines. Images of the central endothelium were obtained preoperatively and at intervals for 10 years postoperatively. Images were analyzed by a central image analysis reading center to determine endothelial cell density (ECD). MAIN OUTCOME MEASURES: Endothelial cell density at 10 years. RESULTS: Among study participants with a clear graft at 10 years, the 125 who received a cornea from a donor 12 to 65 years old experienced a median cell loss of 76%, resulting in a 10-year median ECD of 628 cells/mm(2) (interquartile range [IQR], 522-850 cells/mm(2)), whereas the 51 who received a cornea from a donor 66 to 75 years old experienced a cell loss of 79%, resulting in a median 10-year ECD of 550 cells/mm(2) (IQR, 483-694 cells/mm(2); P adjusted for baseline ECD = 0.03). In addition to younger donor age, higher ECD values were significantly associated with higher baseline ECD (P<0.001) and larger donor tissue size (P<0.001). Forty-two of the 176 participants (24%) had an ECD of <500 cells/mm(2) at 10 years and only 24 (14%) had an ECD of >1000 cells/mm(2). CONCLUSIONS: Substantial cell loss occurs in eyes with a clear graft 10 years after PKP, with the rate of cell loss being slightly greater with older donor age. Greater preoperative ECD and larger donor tissue size are associated with higher ECD at 10 years.
Authors: Mark J Mannis; Edward J Holland; Roy W Beck; Michael W Belin; Marc A Goldberg; Robin L Gal; Andrea D Kalajian; Kenneth R Kenyon; Craig Kollman; Katrina J Ruedy; Patricia Smith; Joel Sugar; Walter J Stark Journal: Cornea Date: 2006-02 Impact factor: 2.651
Authors: Robin L gal; Mariya Dontchev; Roy W Beck; Mark J Mannis; Edward J Holland; Craig Kollman; Steven P Dunn; Ellen L Heck; Jonathan H Lass; Monty M Montoya; Robert L Schultze; R Doyle Stulting; Alan Sugar; Joel Sugar; Bradley Tennant; David D Verdier Journal: Ophthalmology Date: 2008-04 Impact factor: 12.079
Authors: Jonathan H Lass; Robin L Gal; Mariya Dontchev; Roy W Beck; Craig Kollman; Steven P Dunn; Ellen Heck; Edward J Holland; Mark J Mannis; Monty M Montoya; Robert L Schultze; R Doyle Stulting; Alan Sugar; Joel Sugar; Bradley Tennant; David D Verdier Journal: Ophthalmology Date: 2008-04 Impact factor: 12.079
Authors: Alan Sugar; Jean Paul Tanner; Mariya Dontchev; Brad Tennant; Robert L Schultze; Steven P Dunn; Thomas D Lindquist; Robin L Gal; Roy W Beck; Craig Kollman; Mark J Mannis; Edward J Holland Journal: Ophthalmology Date: 2009-04-23 Impact factor: 12.079
Authors: Mark J Mannis; Edward J Holland; Robin L Gal; Mariya Dontchev; Craig Kollman; Dan Raghinaru; Steven P Dunn; Robert L Schultze; David D Verdier; Jonathan H Lass; Irving M Raber; Joel Sugar; Mark S Gorovoy; Alan Sugar; R Doyle Stulting; Monty M Montoya; Jeffrey G Penta; Beth Ann Benetz; Roy W Beck Journal: Ophthalmology Date: 2013-12 Impact factor: 12.079
Authors: Jonathan H Lass; Tonya D Riddlesworth; Robin L Gal; Craig Kollman; Beth A Benetz; Francis W Price; Alan Sugar; Mark A Terry; Mark Soper; Roy W Beck Journal: Ophthalmology Date: 2014-11-15 Impact factor: 12.079
Authors: Thatiane Lima Sampaio; Isabela Pereira Rodrigues; Micheline Borges Lucas Cresta; Anna Cláudia de Oliveira Queiroz; Thayssa Neiva da Fonseca Victer; Daniela Ferreira Salomão Pontes; Wildo Navegantes de Araújo; Sônia Nair Báo; Maria Regina Catai Chalita Journal: Cell Tissue Bank Date: 2020-11-09 Impact factor: 1.522
Authors: Jonathan H Lass; Beth Ann Benetz; Sanjay V Patel; Loretta B Szczotka-Flynn; Robert O'Brien; Allison R Ayala; Maureen G Maguire; Yassine J Daoud; Mark A Greiner; Sadeer B Hannush; W Barry Lee; Thomas F Mauger; Harry J Menegay; Mark D Mifflin; Michael B Raizman; Jennifer Rose-Nussbaumer; Robert L Schultze; Gregory A Schmidt; Alan Sugar; Mark A Terry; David D Verdier Journal: JAMA Ophthalmol Date: 2019-02-01 Impact factor: 7.389
Authors: Naomi Joseph; Chaitanya Kolluru; Beth A M Benetz; Harry J Menegay; Jonathan H Lass; David L Wilson Journal: J Med Imaging (Bellingham) Date: 2020-02-14
Authors: Tonya D Riddlesworth; Craig Kollman; Jonathan H Lass; Sanjay V Patel; R Doyle Stulting; Beth Ann Benetz; Robin L Gal; Roy W Beck Journal: Invest Ophthalmol Vis Sci Date: 2014-11-25 Impact factor: 4.799