Table 1.
Effect of Donor, Recipient, and Operative Factors on Graft Dislocation
| Risk factors | N=1330 | Graft Dislocation n (%) | Base Modela OR (99% CI) | P-value | Multivariable Modelb OR (99% CI) | P-value |
|---|---|---|---|---|---|---|
| Factors included in the final multivariable model | ||||||
| Preservation Time Subgroup | 0.005 | 0.05 | ||||
| 0-7 days | 675 | 39 (6) | 1.00 | 1.00 | ||
| 8-14 days | 655 | 65 (10) | 1.81 (1.05, 3.14) | 1.55 (0.87, 2.78) | ||
| Recipient Diagnosis | 0.58 | 0.62 | ||||
| PACE (without FECD) | 75 | 5(7) | 0.76 (0.21, 2.75) | 0.77 (0.20, 2.94) | ||
| FECD | 1255 | 99 (8) | 1.00 | 1.00 | ||
| Donor history of diabetes | <0.001 | <0.001 | ||||
| No | 973 | 57 (6) | 1.00 | 1.00 | ||
| Yes | 357 | 47 (13) | 2.35 (1.35, 4.08) | 2.29 (1.30, 4.02) | ||
| Operative Complicationc | <0.001 | 0.001 | ||||
| No | 1256 | 89 (7) | 1.00 | 1.00 | ||
| Yes | 74 | 15 (20) | 3.36(1.45, 7.78) | 2.97 (1.24, 7.11) | ||
| Pre-Lamellar Dissection Donor Corneal Thickness (μ)d | 0.001 | 0.004 | ||||
| <550 | 658 | 39 (6) | 1.15 (1.03, 1.28) per 25μ | 1.13 (1.01, 1.27) | ||
| >=550 | 629 | 61 (10) | increase | per 25μ increase | ||
| Factors not included in the final multivariable model | ||||||
| Post-Lamellar Dissection Donor Lenticule Thickness (μ)e | 0.01 | 0.19 | ||||
| < 100 | 216 | 14(6) | 1.21 (0.99, 1.49) | 1.12 (0.89, 1.40) | ||
| 100 - <125 | 403 | 30 (7) | per 25μ increase | per 25μ increase | ||
| 125 - <150 | 339 | 22 (6) | ||||
| ≥150 | 305 | 31 (10) | ||||
| Any Eye Bank Observations | 0.15 | 0.22 | ||||
| No | 795 | 59 (7) | 1.00 | 1.00 | ||
| Yes | 192 | 23 (12) | 1.72 (0.82, 3.61) | 1.56 (0.73, 3.34) | ||
| Surgeon prepared tissue | 343 | 22 (6) | 0.94 (0.36, 2.47) | 0.78 (0.25, 2.48) | ||
PACE = Pseudophakic/aphakic corneal edema; FECD = Fuchs endothelial corneal dystrophy; DSAEK = Descemet stripping automated endothelial keratoplasty; OR= Odds ratio
Base models adjusted for preservation time, recipient diagnosis, and random surgeon effect
Multivariable model adjusted for preservation time, recipient diagnosis, and random surgeon effect. Donor history of diabetes, operative complications, and pre-lamellar dissection donor corneal thickness were retained in the final model via backward selection.
Operative complications include vitreous loss (unplanned), posterior capsule rupture, suprachoroidal hemorrhage, significant hyphema, inverted donor tissue, difficult unfolding and positioning without use of positioning hook, difficult unfolding and positioning with use of positioning hook, difficult air fill and retention in positioning, reinsertion of donor after extrusion, and other write-ins
Pre-lamellar dissection donor corneal thickness is missing for 43 eyes. Eye bank determined by optical coherence tomography (586 eyes), ultrasonic pachymetry (337 eyes), specular microscopy (57 eyes), optical (7 eyes). Surgeon determined by ultrasonic pachymetry (299 eyes), non-ultrasonic method (1 eye)
Post-lamellar dissection donor lenticule thickness is missing for 67 eyes. Eye bank determined by optical coherence tomography (703 eyes), ultrasonic pachymetry (216 eyes), specular microscopy (58 eyes), optical (10 eyes). Surgeon determined by ultrasonic pachymetry (276 eyes)