title: Visual Recovery and Clinical Outcomes With Torn Donor Tissue: A Comparative Study on Descemet Membrane Endothelial Keratoplasty.
abstract: OBJECTIVE
  To evaluate the clinical impact of implanting donor tissue torn during preparation for the Descemet membrane endothelial keratoplasty procedure.
  
  
  METHODS
  In this single-center retrospective analysis of consecutive cases, 10 cases with torn donor tissue from one surgeon's caseload of 175 procedures were analyzed and compared with control cases. Best-corrected visual acuity, endothelial cell density of the donor tissue measured by specular microscopy, and the recipient's central corneal thickness were recorded preoperatively and again 1, 3, and 6 months after surgery.
  
  
  RESULTS
  In the torn graft group, mean central corneal thickness decreased from 660 ± 81 μm preoperatively to 520 ± 36 μm at 6 months after surgery. central corneal thickness was higher at 1 month but decreased faster between 1 and 3 months in the torn graft group compared with the controls (-86 ± 50.2 μm and -12.6 ± 25.5 μm, respectively, P = 0.04). Best-corrected visual acuity in the torn graft group was 0.25 ± 0.23 logMAR, 0.21 ± 0.20 logMAR, and 0.16 ± 0.16, respectively, at 1, 3, and 6 months after surgery with no significant differences found when compared with controls. The percent endothelial cell loss between the preoperative and 1-month postoperative values was significantly higher in the torn graft group than in the controls (32.3% and 24.6%, respectively, P = 0.04) but was identical at 6 months (35.7% in the torn graft group and 34.8% in the control group).
  
  
  CONCLUSIONS
  Anatomical recovery was shown to be slower in patients who received torn donor tissue, but long-term clinical outcomes were similar in both groups.
authors.affiliation: *Department of Ophthalmology, Rothschild Foundation, Rue Manin, Paris, France; and†CEROC (Center of Expertise and Research in Optics for Clinicians), Paris, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Panthier
authors.forename: Romain
authors.initials: R
authors.lastname: Courtin
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Guilbert
authors.forename: Damien
authors.initials: D
authors.lastname: Gatinel
authors.forename: Alain
authors.initials: A
authors.lastname: Saad
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002452:Cell Count; D003316:Corneal Diseases / Q000601:surgery; D055954:Corneal Endothelial Cell Loss / Q000473:pathology; D063171:Corneal Pachymetry; D057111:Descemet Stripping Endothelial Keratoplasty; D004728:Endothelium, Corneal / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D020127:Recovery of Function / Q000502:physiology; D012189:Retrospective Studies; D014019:Tissue Donors; D066027:Transplant Recipients; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*