LAUSR

PURPOSE The purpose of this study was to investigate whether donor corneas aged ≥80 years are suitable for Descemet Membrane Endothelial Keratoplasty (DMEK). DESIGN Retrospective, comparative, interventional case series. METHODS Records of 1765 consecutive DMEKs were reviewed and matched with corresponding donor tissue data. Older donors (age ≥80 years) were compared to younger donors (<80 years). Outcome measures in DMEK recipients included best spectacle-corrected visual acuity (BSCVA), endothelial cell density (ECD), central corneal thickness (CCT) at 3, 6 months, 1, 2, and 3 year follow-up and re-bubbling rates. RESULTS Out of 1748 included DMEKs, 284 (16.2%) were performed with older donor lamellae (mean donor age 83.96 ± 3.19 years; range: 80-94) and 1464 (83.7%) with younger donor tissue (mean donor age 65.27 ± 9.57 years; range: 17-79). BSCVA results were comparable for all postoperative time points. CCT results for younger donors were more favorable in the early postoperative course (6 months: P <.001; 1 year: P <.001), whereas mid-term results were comparable in both groups. ECD values were significantly higher in donors <80 years preoperatively and during the first 2 postoperative years (P ≤.024). Overall re-bubbling rate was comparable in both groups. CONCLUSION Older donor age ≥80 up to 94 years seems to produce comparable mid-term functional results following DMEK surgery when compared to younger donors. The use of corneas from donors aged ≥80 for DMEK surgery might therefore be a promising approach to counteract global donor shortage.