Donor Diabetes Severity Not Linked to DMEK Graft Outcomes

A secondary analysis of a multicenter randomized trial examined whether cornea donor diabetes severity, measured by severity score, postmortem HbA1c, and advanced glycation/oxidation end products, affected 1-year outcomes after Descemet membrane endothelial keratoplasty (DMEK). Among 1097 patients (1421 eyes), the study reported no significant association between donor diabetes severity and graft failure, endothelial cell loss, or cell morphometry at 1 year, with comparable graft success rates across donor HbA1c categories. The authors state these findings support use of corneas from donors with diabetes for endothelial keratoplasty without additional preoperative testing or risk stratification based on donor diabetes status.

Most relevant for: Corneal surgeons and eye bank clinicians involved in donor selection and DMEK for conditions such as Fuchs endothelial corneal dystrophy.

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