Tissue Characteristics and Reported Adverse Events After Corneal Transplantation

Purpose:To determine whether donor or tissue characteristics of corneas for transplantation are predictive of reported adverse events occurring in the early postoperative period.Methods:We compared preoperative donor and tissue characteristics of corneal tissues with or without reported adverse events from 2007 to 2011. Adverse event categories included primary graft failure, infection, surgical causes, recipient-related etiologies, and other causes. We included corneas transplanted via penetrating keratoplasty (PK) and endothelial keratoplasty (EK).Results:Of 20,431 tissues included, there were 251 (1.2%) reported adverse events. Among all transplanted tissues, 67% were used for PK, and 33% were used for EK. The adverse event occurrence rate was 0.78% in PK versus 2.12% in EK (P < 0.0001). The donor characteristics associated with adverse events were male gender (P = 0.01) and cancer history (P = 0.03), which were associated with primary graft failure. In PK, the most frequently reported causes within 106 adverse events were recipient-related causes (n = 41, 0.30% of total PK tissues) and infection (n = 31, 0.23%). In EK, the most frequently reported causes within 145 adverse events were surgical complications (n = 72, 1.05% of total EK tissues) and primary graft failure (n = 41, 0.60%).Conclusions:The rate of reported adverse events was low. Adverse events more commonly occurred after EK. Increased rate of primary graft failure was associated with male donors and donors with a cancer history. Postcut tissue thickness, only in the year 2007, was the sole tissue characteristic associated with adverse events.