Changing risk for early transplant failure: data from the Ontario Corneal Recipient Registry

To examine the joint effects of donor, recipient and surgical characteristics on the risk of early corneal transplant failure, 73 cases of early failure (no period of clarity or clarity lasting no more than 28 days) reported to the Ontario Corneal Recipient Registry were compared with 1591 control transplants remaining clear for 6 months or more. In logistic regression models donor age was significantly associated with graft failure, with the odds of failure increasing by 24% per decade. In recipients with a history of cataract or glaucoma or with an intraocular lens in place the relative odds of failure ranged from 2.16 to 3.08. Among surgical factors, larger grafts increased risk by 45% per 0.25 mm. Grafts received before 1987 had a consistently higher risk of early failure than those received in 1987 or later. Concurrent changes in storage media, handling of donor tissue and management of recipients may have been responsible. We conclude that donor, recipient and surgical factors all contribute to the risk of early transplant failure.