Related Experiment Video
Updated: Jun 20, 2026
Corneal Donor Tissue Preparation for Descemet's Membrane Endothelial Keratoplasty
Published on: September 17, 2014
Factors involved in the occurrence of bleeding complications after enucleation for cornea donation
Marja J van Wijk1, Matthijs V Nijenhuis, Caroline A Dorrepaal
1Foundation, 2301 CH Leiden, The Netherlands. m.vanwijk@bisfoundation.nl
Insights
The retrieval sequence of tissues significantly impacts bleeding risks during cornea donation. Performing cornea donation last minimizes bleeding complications and ocular hematomas, but may affect corneal quality.
Area of Science:
- Ophthalmology
- Transplantation Medicine
- Public Health
Background:
- Bleeding complications, including ocular hematomas, can occur after cornea donation.
- Identifying risk factors is crucial for developing preventive strategies.
Purpose of the Study:
- To identify risk factors for bleeding complications after enucleation for cornea donation.
- To develop preventive activities to reduce bleeding complications and ocular hematomas.
Main Methods:
- Data from Dutch cornea donors in 2006 were collected, including donor and retrieval characteristics.
- Univariate analyses identified initial associations between factors and bleeding complications.
- Multivariate logistic regression analysis pinpointed significant risk factors.
Main Results:
- Bleeding complications occurred in 9.7% of donors; ocular hematomas in 3.3%.
- Significant donor factors included age, weight, heart failure, thrombocyte aggregation inhibitor use, and alcoholic liver disease.
- The most significant factor was the retrieval sequence; performing cornea donation after other tissue retrievals increased bleeding risk.
Conclusions:
- Tissue retrieval sequence is the primary factor influencing bleeding complications in multitissue donors.
- Cornea donation after other retrievals lowers bleeding and ocular hematoma risk.
- Altering the retrieval sequence requires consideration of postmortem time's effect on corneal quality.
Purpose:
To identify risk factors for the occurrence of bleeding complications after enucleation for cornea donation, in order to develop preventive activities to reduce the occurrence of bleeding complications and especially the development of ocular hematomas.
Methods:
From all Dutch cornea donors deceased in the year 2006, donor characteristics, retrieval characteristics, and bleeding complication data were collected. First, univariate relations between donor and retrieval factors and bleeding complications were determined. Then, multivariate logistic regression analysis was used to identify factors significantly associated with bleeding complications.
Results:
In 114 of the 1173 cornea donors (9.7%), bleeding complications occurred, with ocular hematomas developing in 39 (3.3% of all cornea donors). Donor factors significantly associated with bleeding complications were age [odds ratio (OR) 0.96 (95% CI 0.94-0.97)], weight [OR 1.03 (1.02-1.04)], heart failure [OR 2.10 (1.12-3.94)], thrombocyte aggregation inhibitor use [OR 1.64 (1.02-2.64)], and chronic alcoholic liver disease [OR 2.85 (1.11-7.31)]. The most significant factor associated with bleeding complications was the retrieval sequence. If cornea donation was followed by any other tissue retrieval, the risk of bleeding complications was strongly increased.
Conclusions:
: This study shows that the tissue retrieval sequence in multitissue donors is the most important factor associated with the occurrence of bleeding complications. The risk of bleeding and ocular hematoma is lower if cornea donation is performed after all other retrievals. However, if the tissue retrieval sequence is altered, the effect of prolonged postmortem time on corneal quality must be taken into account.
