Longitudinal Trends in Tissue-Related Adverse Events After Corneal Transplantation

Area of Science:

• Ophthalmology
• Transplantation Science
• Biostatistics

Background:

• Longitudinal trends of tissue-related adverse events (AEs) following corneal transplantation are not well understood.
• Understanding these trends is crucial for eye banks and clinicians to assess and mitigate risks associated with corneal tissue transplantation.

Purpose of the Study:

• To analyze the longitudinal trends of tissue-related adverse events (AEs) in corneal transplantation procedures.
• To identify changes in AE rates over time and across different corneal transplantation techniques.

Main Methods:

• A trend study analyzing data from 126,072 corneal donor tissues obtained from Eversight Eye Bank between May 2007 and December 2024.
• Longitudinal analysis of surgeon-reported AEs, focusing on tissue-related causes, and assessment of AE types and procedural types (PKP, DSAEK, DMEK).

Main Results:

• A total of 176 tissue-related AEs were identified, with an overall prevalence of 0.14%.
• A significant annual reduction in the odds of AEs was observed (6.7% yearly reduction, 69.2% over 17 years).
• While DSAEK and DMEK showed higher initial odds of AEs compared to PKP, rates of infectious keratitis and primary graft failure significantly improved year over year across all procedures.

Conclusions:

• Adverse event rates in corneal transplantation have consistently declined, indicating enhanced safety and quality in eye banking and surgical practices.
• Improvements were noted across various corneal transplantation procedures (PKP, DMEK, DSAEK) and specific adverse events, including infectious keratitis and graft failure.