Eye bank tissue utilization between endothelial keratoplasty and penetrating keratoplasty

To determine rates of tissue use for corneal transplants via endothelial keratoplasty (EK) relative to penetrating keratoplasty (PK).

Retrospective chart review of all cornea tissues (n = 3669) distributed from the Lions Eye Bank of Wisconsin for EK or PK from August 1, 2004 through July 31, 2009 (60 months). Rates of tissue use for EK relative to PK were determined both on a yearly basis and for the overall study period. Replacement frequency and time to subsequent surgery were established for each group. Donor tissue and recipient characteristics were compared between groups.

Donor characteristics did not differ between the 2 groups; 11.9% of EK tissues failed and were replaced during the study period compared with 5.1% of PK tissues (P < 0.0001). Additional tissue for the same eye came at a mean of 174 days after an EK surgery compared with 558 days after a PK (P < 0.0001). Surgeons requesting tissue for EK increased each year, whereas the number of repeat tissue requests decreased over time.

Additional tissues were required for recipients of EK more than twice as often as for recipients of PK, and replacement of EK grafts occurred at a mean of more than 1 year before replacement of PK grafts. This pattern of tissue utilization during the first 5 years of distribution for EK did not negatively affect the Lions Eye Bank of Wisconsin from meeting the surgeon demand for tissue in its service area. Eye banks may wish to monitor tissue utilization as part of their quality assurance program.