Cornea Donor Study

2014-08-27 03:57:22 | BioPortfolio


The Cornea Donor Study (CDS) was designed as a prospective cohort study with the following objectives:

To determine whether the graft-failure rate over a 5-year follow-up period following corneal transplantation is the same when using corneal tissue from donors older than 65 years of age compared with tissue from younger donors.

To assess the relationship between donor/recipient ABO blood type compatibility and graft failure due to rejection.

To assess corneal endothelial cell density as an indicator of the health of the cornea and as a alternate outcome measure (in an optional Specular Microscopy Ancillary Study).


The study enrolled 1101 subjects with a corneal disease considered to be at moderate risk for failure (principally Fuchs' dystrophy and pseudophakic corneal edema). A donor cornea meeting the following criteria was assigned to the subject by one of 43 participating eye banks:

- donor age 10 to 75 years

- endothelial cell count 2300 to 3300

- tissue quality very good to excellent

- death to preservation time <12 hrs if body refrigerated or eyes on ice and <8 hrs if not

- death to surgery time <5 days

The cornea surgeon (investigator) and patient were masked to donor age and characteristics of the donor cornea. Preoperative management, surgical technique, and postoperative care, including prescription of medications, were provided according to each investigator's customary routine. The follow-up visit schedule for the initial six months was left to each investigator's discretion and after this time the minimum follow-up visit schedule included a visit between six and 12 months and then one visit every 12 months through five years. The primary study outcome was graft survival at five years. The definition of graft failure, based on the definition used in Collaborative Corneal Transplantation Studies, was a regraft or, in the absence of regraft, a cloudy cornea in which there was loss of central graft clarity sufficient to compromise vision for a minimum of three consecutive months. Follow-up in the initial phase of the study continued for five years unless the patient had a regraft of the study eye.

For the ABO compatibility study, the ABO blood type of both the donor and recipient were determined in order to compare the rate of graft failure for ABO-compatible cases with the rate for ABO-incompatible cases.

For the Specular Microscopy Ancillary Study, endothelial cell counts were determined from specular images by a central reading center, and the relationship of the cell counts to donor age were assessed. In the initial phase of the study, specular images were obtained at 6 months, and then annually through five years post-transplant.

Five-year follow up was completed in November 2007. The 5-year cumulative probability of success was 86%: 86% in the <66.0 year donor age group and 86% in the >=66.0 year donor age group (difference = 0%, upper limit of one-sided 95% confidence interval = 4%). Adjusting for baseline endothelial cell density had no appreciable effect on these results. In a statistical model with donor age as a continuous variable, there was not a significant relationship between donor age and outcome (P=0.11). Three graft failures were due to primary donor failure, 8 to uncorrectable refractive error, 48 to graft rejection, 46 to endothelial decompensation, and 30 to other causes. At least one probable or definite graft rejection episode preceded graft failure in 23 of the 46 failures attributed to endothelial decompensation (4 definite and 19 probable) and in 18 of the 30 failures attributed to other causes (4 definite and 14 probable). The distribution of causes of failure between the donor age groups did not substantially differ.

Although the 5-year results indicated no difference in the success rate of moderate-risk transplants according to donor age, results from the SMAS indicated that among the successful cases, there was a slight association between donor age and endothelial cell loss, with the cell loss after 5 years being slightly lower in corneas from younger donors (r adjusted for baseline endothelial cell density = -0.19, 95% confidence interval -0.29 to -0.08). Whether this slight association between cell loss and donor age is of clinical importance is not known. Of perhaps even greater importance, however, was the finding that irrespective of donor age, endothelial cell loss was substantial over the first five years after transplant even when the graft had been successful. Half of the successful cases experienced a cell loss of 70% or more, and at five years more than half had an endothelial cell density <800 cells/mm2.

The CDS will continue and patients will be followed annually through 2012 in order to to determine the overall 10-year survival rate for moderate risk grafts and to determine whether the graft-failure rate is related to donor age. Additional objectives include determining the value of endothelial cell density in predicting graft failure and evaluating donor and recipient characteristics that may be predictive of late graft failure. All CDS subjects who are active at the 5-year exam are eligible for the extended follow-up phase.

As part of the Specular Microscopy Ancillary Study, follow-up images will be obtained during the extended follow-up phase at 7-8 years and again at 10-years. The same procedures used during the first 5 years will be followed for the grading of the 7-8 year and 10-year images.

Study Design

Endpoint Classification: Bio-equivalence Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator, Outcomes Assessor)


Corneal Disease


corneas assigned by donor age group


Jaeb Center for Health Research, Inc.
United States


Active, not recruiting


National Eye Institute (NEI)

Results (where available)

View Results


Published on BioPortfolio: 2014-08-27T03:57:22-0400

Clinical Trials [1802 Associated Clinical Trials listed on BioPortfolio]

Life 4°C Versus Optisol in Corneal Storage Media

The purpose of this study is to compare the success of storing a donor cornea in Optisol GS, the current standard vs. storing the donor cornea in Life4°C, a newer solution. The donor corn...


This study will assess changes in visual acuity and corneal symmetry after corneal collagen cross-linking (CXL) of asymmetric corneas.

Corneal Collagen Cross-linking With Hypotonic Riboflavin in Corneas Thinner Than 400 Microns

Corneal ectasia is a relative weakness in the structure of the cornea, which produces a progressive change in its shape which results in visual distortion. It is known that collagen cross...

OCT in Diagnosis of Irregular Corneas

This main goal of this study is to improve the detection, classification, monitoring, and treatment of irregular corneas due to keratoconus, warpage, dry eye, scar, stromal dystrophies, an...

Corneal Cross-linking and Refractive Surface Ablation in Patients With Asymmetric Corneas

The purpose of this study is to evaluate safety and efficacy of corneal cross-linking and photorefractive keratectomy for refractive correction in patients with bilateral asymmetric topogr...

PubMed Articles [23930 Associated PubMed Articles listed on BioPortfolio]

Outcome of Human Donor Corneas Stored for More Than 4 Weeks.

Organ culture is the most common method for preservation of human donor corneas within Europe, and the maximum accepted storage period is typically set to 4 weeks. However, little is known about the f...

Pre-cut post-LASIK/PRK donor corneas for use in endothelial keratoplasty: potential impact of post-cut morphology on visual outcomes.

To evaluate the accuracy, complication rates, cut quality, and degree of induced hyperopic shift of eye bank-prepared post-LASIK/PRK donor corneas compared to that of non-post-LASIK/PRK donor corneas.

Optically robust, highly permeable and elastic protein films that support dual cornea cell types.

Damaged corneas can lead to blindness. Due to the worldwide shortage of donor corneas there is a tremendous unmet demand for a robust corneal replacement that supports growth of the major corneal cell...

Geometric Properties of Donor Corneas After Mechanical Trephination in Deep Anterior Lamellar Keratoplasty.

To evaluate the geometry of donor corneal buttons after mechanical trephination and to determine whether there were any possible variables that could influence the accuracy of cutting corneal buttons ...

An integrated deep sequencing analysis of microRNAs in transplanted corneas.

Illumina Hiseq 2500 deep sequencing was used to screen for differentially expressed genes (DEGs) in matched pairs of isograft corneas and normal corneas, allograft corneas and isograft corneas. Our re...

Medical and Biotech [MESH] Definitions

A surgical procedure or KERATOPLASTY involving selective stripping and replacement of diseased host DESCEMET MEMBRANE and CORNEAL ENDOTHELIUM with a suitable and healthy donor posterior lamella. The advantage to this procedure is that the normal corneal surface of the recipient is retained, thereby avoiding corneal surface incisions and sutures.

A corneal disease in which there is a deposition of phospholipid and cholesterol in the corneal stroma and anterior sclera.

Transferases are enzymes transferring a group, for example, the methyl group or a glycosyl group, from one compound (generally regarded as donor) to another compound (generally regarded as acceptor). The classification is based on the scheme "donor:acceptor group transferase". (Enzyme Nomenclature, 1992) EC 2.

New blood vessels originating from the corneal veins and extending from the limbus into the adjacent CORNEAL STROMA. Neovascularization in the superficial and/or deep corneal stroma is a sequel to numerous inflammatory diseases of the ocular anterior segment, such as TRACHOMA, viral interstitial KERATITIS, microbial KERATOCONJUNCTIVITIS, and the immune response elicited by CORNEAL TRANSPLANTATION.

A mismatch between donor and recipient blood. Antibodies present in the recipient's serum are directed against antigens in the donor product. Such a mismatch may result in a transfusion reaction in which, for example, donor blood is hemolyzed. (From Saunders Dictionary & Encyclopedia of Laboratory Medicine and Technology, 1984)

More From BioPortfolio on "Cornea Donor Study"

Quick Search


Relevant Topics

Ophthalmology is the branch of medicine that is devoted to the study and treatment of eye diseases. As well as mild visual defects correctable by lenses, ophthalmology is concerned with glaucoma, uveitis and other serious conditions affecting the eye, ...

Organ transplantation is the moving of an organ from one body to another or from a donor site to another location on the patient's own body, for the purpose of replacing the recipient's damaged or absent organ. The emerging field of regenerative ...

Searches Linking to this Trial