{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:25:17Z","timestamp":1777447517125,"version":"3.51.4"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,2,4]],"date-time":"2022-02-04T00:00:00Z","timestamp":1643932800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004336","name":"Novartis","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004336","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>To identify donor-related risk factors associated with graft endothelial failure and postoperative endothelial cell density (ECD) reduction after Descemet's stripping automated endothelial keratoplasty (DSAEK).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a single-center retrospective study conducted from July 2006-December 2016. We included 584 consecutive eyes (482 patients) that underwent DSAEK for the treatment of laser iridotomy-related bullous keratopathy (192 eyes), pseudophakic bullous keratopathy (137 eyes), regraft (96 eyes), Fuchs' endothelial corneal dystrophy (FECD; 59 eyes) and others (100 eyes). Twenty-three donor- and recipient-related risk factors potentially associated with graft failure and ECD reduction were assessed using Cox hazard models and linear mixed effect models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median age of the patients was 73.5 years (male; 35.6%). After DSAEK, ECD decreased from 2,674 cells\/mm<jats:sup>2<\/jats:sup> (95% confidence interval [CI]; 2,646\u20132,701) to 1,132 (1,076\u20131,190) at 12 months and 904 (845\u2013963) at 24 months (<jats:italic>P<\/jats:italic> &amp;lt; 0.001). Fifty-five eyes (9.4%) had graft endothelial failure without rejection. This failure was associated with donor pseudophakic lens status (hazard ratio [HR]; 2.67, CI; 1.50\u20134.76, <jats:italic>P<\/jats:italic> = 0.001) and preoperative endothelial folds (HR; 2.82, CI; 1.20\u20136.62, <jats:italic>P<\/jats:italic> = 0.02). The incidence of graft endothelial failure in non-FECD patients was significantly higher among those receiving donor grafts with a pseudophakic lens status and preoperative presence of endothelial folds (<jats:italic>P<\/jats:italic> &amp;lt; 0.001). Postoperative ECD loss was significantly greater in eyes with these risk factors compared to those without (<jats:italic>P<\/jats:italic> = 0.007).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Pseudophakic status and\/or presence of preoperative endothelial folds are the significant donor risk factors for endothelial failure in non-FECD patients.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2022.810536","type":"journal-article","created":{"date-parts":[[2022,2,4]],"date-time":"2022-02-04T06:16:45Z","timestamp":1643955405000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Donor-Related Risk Factors for Graft Decompensation Following Descemet's Stripping Automated Endothelial 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