Predictive Value of Corneal Donor Demographics on Endothelial Cell Density.

Abstract

Corneal endothelial cell density (ECD) is an important measure for determining suitability for transplantation. Although age has been correlated with ECD, the impact of sex and ethnicity is unclear. Corneal donor information from SightLife Eye Bank was collected between 2012 and 2016. Tests of association were adjusted for covariates using linear regression including age, race, and sex. "Unsuitable for transplantation" was a label assigned to specimens with extensive cell dropout, ECD <2000 cells/mm, and poor cell morphology. Repeated-measures analysis was used to account for the within-individual correlation between left and right eyes. A total of 39,679 donor corneas were analyzed, with a mean ECD 2743.5 cells/mm and mean age of 58. Simple linear regression demonstrated an association between ECD and age (P < 0.001). Multiple regression showed no association between sex and ECD. Compared with whites, African American, and Asian ethnicities were predictors of increased ECD (mean +45.7 cells/mm (P < 0.001) and +90.3 cells/mm (P < 0.001), respectively); Hispanic ethnicity was a predictor of decreased ECD [mean -36.9 cells/mm (P = 0.002)]. A total of 233 (0.59%) corneas were unsuitable for transplantation, which was associated with age (P < 0.001) but not sex or ethnicity. Analysis of a large sample of donor corneas continues to show age but not sex as a predictor of decreased ECD. African American and Asian ethnicities tend to have slightly higher ECD than that of white donors, whereas Hispanic donors have slightly lower ECD; however, ethnicity was not a predictor of suitability for transplantation. Clinical significance of these findings is yet to be determined.