title: Baseline factors related to endothelial cell loss following penetrating keratoplasty.
abstract: OBJECTIVE
  To identify baseline (donor, recipient, and operative) factors that affect endothelial cell loss following penetrating keratoplasty for a moderate-risk condition (principally Fuchs dystrophy or pseudophakic or aphakic corneal edema).
  
  
  METHODS
  In a subset (n = 567) of Cornea Donor Study participants, preoperative and postoperative endothelial cell densities (ECDs) were determined by a central reading center. Multivariate regression analyses were performed to examine which baseline factors correlated with ECD over time.
  
  
  RESULTS
  Larger grafts (P < .001), younger donor age (P < .001), and female donor (P = .004) were significantly associated with higher ECD during follow-up. Median endothelial cell loss at 5 years was 68% for grafts larger than 8.0 to 9.0 mm in diameter, 75% for grafts 7.0 mm to smaller than 8.0 mm in diameter, and 74% for grafts 8.0 mm in diameter. Grafts from female donors experienced a 67% cell loss compared with a 72% cell loss among grafts from male donors. Method of tissue retrieval, donor cause of death, history of diabetes, and time from death to preservation or to surgery were not significantly associated with changes in ECD over time.
  
  
  CONCLUSIONS
  Following penetrating keratoplasty for endothelial dysfunction conditions, larger donor graft size, younger donor age, and female donor were associated with higher ECD over 5 years. These data warrant exploring the possibility that similar associations may exist following endothelial keratoplasty.
  
  
  BACKGROUND
  clinicaltrials.gov Identifier: NCT00006411.
authors.affiliation: Department of Ophthalmology and Visual Sciences, Case Western Reserve University and University Hospitals Eye Institute, Cleveland, Ohio, USA. cds@jaeb.org
authors.forename: Jonathan H
authors.initials: JH
authors.lastname: Lass
authors.forename: Roy W
authors.initials: RW
authors.lastname: Beck
authors.forename: Beth Ann
authors.initials: BA
authors.lastname: Benetz
authors.forename: Mariya
authors.initials: M
authors.lastname: Dontchev
authors.forename: Robin L
authors.initials: RL
authors.lastname: Gal
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Holland
authors.forename: Craig
authors.initials: C
authors.lastname: Kollman
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Mannis
authors.forename: Francis
authors.initials: F
authors.lastname: Price
authors.forename: Irving
authors.initials: I
authors.lastname: Raber
authors.forename: Walter
authors.initials: W
authors.lastname: Stark
authors.forename: R Doyle
authors.initials: RD
authors.lastname: Stulting
authors.forename: Alan
authors.initials: A
authors.lastname: Sugar
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002452:Cell Count; D003316:Corneal Diseases / Q000601:surgery; D055954:Corneal Endothelial Cell Loss / Q000209:etiology*; D004728:Endothelium, Corneal / Q000473:pathology; D005260:Female; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors; D014019:Tissue Donors