Table 2.
Association between baseline factors and graft endothelial failure.
| Log-rank test | Multivariate models* | ||||
|---|---|---|---|---|---|
| Prognostic factor | n | 2-year graft survival (95% CI) | P | HR (95% CI) | P |
| Donor age, y | |||||
| 18–65 | 281 | 0.91 (0.86–0.94) | 0.04 | 1 [reference] | 0.48 |
| 66–96 | 303 | 0.85 (0.80–0.89) | 1.23 (0.69–2.19) | ||
| Donor sex | |||||
| Male | 373 | 0.90 (0.86–0.93) | 0.13 | ||
| Female | 211 | 0.86 (0.79–0.90) | |||
| Imported graft | |||||
| No | 157 | 0.89 (0.85–0.92) | 0.48 | ||
| Yes | 427 | 0.87 (0.79–0.92) | |||
| History of diabetes mellitus | |||||
| No | 444 | 0.91 (0.87–0.93) | 0.007 | 1 [reference] | 0.09 |
| Yes | 140 | 0.81 (0.72–0.87) | 1.63 (0.93–2.86) | ||
| Cigarettes smoking | |||||
| No | 323 | 0.87 (0.82–0.91) | 0.42 | ||
| Yes | 261 | 0.90 (0.84–0.93) | |||
| Alcohol consumption | |||||
| No | 378 | 0.87 (0.82–0.90) | 0.22 | ||
| Yes | 206 | 0.91 (0.85–0.94) | |||
| Drug abuse | |||||
| No | 511 | 0.89 (0.85–0.91) | 0.55 | ||
| Yes | 73 | 0.85 (0.72–0.92) | |||
| History of LASIK | |||||
| No | 550 | 0.88 (0.85–0.91) | 0.92 | ||
| Yes | 34 | 0.89 (0.70–0.96) | |||
| Donor lens status | |||||
| Phakic | 487 | 0.91 (0.88–0.94) | <0.001 | 1 [reference] | 0.001 |
| IOL | 97 | 0.73 (0.62–0.81) | 2.67 (1.50–4.76) | ||
| Cause of death | |||||
| Cancer | 147 | 0.87 (0.83–0.90) | 0.22 | ||
| Non-cancer | 437 | 0.93 (0.86–0.96) | |||
| Refrigerated/on ice | |||||
| No | 241 | 0.89 (0.84–0.93) | 0.68 | ||
| Yes | 343 | 0.88 (0.83–0.91) | |||
| Time from death to the preservation, h | |||||
| 1.8–7.9 | 287 | 0.89 (0.84–0.92) | 0.49 | ||
| 8.0–26.9 | 297 | 0.87 (0.82–0.91) | |||
| Time from death to operation, d | |||||
| 1.8–6.8 | 289 | 0.88 (0.82–0.91) | 0.47 | ||
| 6.9–9.6 | 295 | 0.89 (0.84–0.92) | |||
| Graft ECD, cells/mm 2 | |||||
| 2,010–2,636 | 292 | 0.85 (0.80–0.89) | 0.06 | ||
| 2,637–3,812 | 292 | 0.91 (0.87–0.94) | |||
| Endothelial folds† | |||||
| None | 157 | 0.95 (0.89–0.98) | 0.003 | 1 [reference] | 0.02 |
| Mild to moderate | 427 | 0.86 (0.81–0.89) | 2.82 (1.20–6.62) | ||
| Recipient age at DSAEK, y | |||||
| 15–72 | 259 | 0.87 (0.82–0.91) | 0.56 | ||
| 73–92 | 325 | 0.89 (0.84–0.92) | |||
| Recipient sex | |||||
| Male | 208 | 0.85 (0.78–0.90) | 0.23 | ||
| Female | 376 | 0.90 (0.86–0.93) | |||
| Etiology | |||||
| FECD | 59 | 0.98 (0.85–1.00) | 0.04 | 1 [reference] | 0.09 |
| Non-FECD | 525 | 0.87 (0.83–0.90) | 5.50 (0.76–39.93) | ||
| Recipient lens status | |||||
| Phakic | 244 | 0.90 (0.84–0.93) | 0.53 | ||
| IOL/Aphakic | 340 | 0.88 (0.83–0.91) | |||
| Simultaneous CS | |||||
| No | 395 | 0.87 (0.83–0.90) | 0.15 | ||
| Yes | 189 | 0.92 (0.86–0.95) | |||
| Re-bubbling | |||||
| No | 505 | 0.88 (0.85–0.91) | 0.18 | ||
| Yes | 79 | 0.82 (0.67–0.91) | |||
| Central graft thickness, μm‡ | |||||
| 53–130 | 167 | 0.85 (0.75–0.91) | 0.93 | ||
| 131–270 | 336 | 0.89 (0.84–0.92) | |||
| Graft diameter, mm | |||||
| 6.75–7.75 | 144 | 0.89 (0.85–0.91) | 0.80 | ||
| 8.00–8.75 | 440 | 0.89 (0.81–0.93) | |||
CI, confidence interval; CS, cataract surgery; DSAEK, Descemet's stripping automated endothelial keratoplasty; ECD, endothelial cell density; FECD, Fuchs' endothelial corneal dystrophy; HR, hazard ratio; LASIK, laser-assisted in situ keratomileusis; IOL = intraocular lens.
Cox proportional hazard regression analysis.
Grafts without folds were defined as having “no graft folds,” “mild graft folds” were defined by the presence of graft folds limited to <25% of the area of the total cornea, and “moderate graft folds” were defined by the presence of graft folds occupying more than 25% of the area of the total cornea.
Bold numbers indicate P < 0.05.
Central graft thickness data was obtained in 503 eyes.