Nationwide Study Aims to Determine Which Diabetic Individuals Should Donate Corneas for DMEK

Article: Case Western Reserve-led research team aims to determine which diabetic individuals can successfully donate corneas for transplant (and which should not)
Source: Case Western Reserve University, via Corneal Physician
Published: June 3, 2021

A new study funded by the National Eye Institute aims to determine which diabetic individuals can successfully donate corneas for transplant, and which should not. The new Diabetes Endothelial Keratoplasty Study (DEKS) will involve 16 eye banks and 30 clinical sites around the country, with an anticipated 1,420 donors and over 1,000 patients. Although recent eye bank data suggest that roughly one-third of the corneal transplant surgeries in the United States involve people with diabetes who donate their corneas after death, the medical community has learned that not all corneal tissue from diabetics is suitable for keratoplasty. The number of diabetic donors has also seen a 50-72% increase in recent years simply because the number of diabetics has increased. The study will focus on Descemet membrane endothelial keratoplasty (DMEK), the most common procedure performed by high-volume corneal transplant surgeons. Previous research showed that there were more problems encountered when preparing corneas from diabetic donors for the DMEK procedure, leading many surgeons to increasingly avoid corneas from diabetic donors for DMEK. One of the researchers adds, “This study could also help identify some of the reasons why 2 to 3% of donated corneas fail for no apparent reason, which is a reason for frustration among patients and surgeons.” Goals of the study include comparing the one-year keratoplasty success rate following DMEK with corneas from donors with and without diabetes, comparing the one-year endothelial cell loss in the central cornea after DMEK with corneas from donors with and without diabetes, and exploring how the severity of a donor’s diabetes affects outcomes one year after DMEK surgery. This study is especially relevant given the steady rise in corneal transplant surgeries in recent years (accounting for the lull during the COVID-19 pandemic). Knowing how diabetes affects the success of corneal surgeries can help to screen for effective tissue donors for corneal cases. Equally important, the study results will provide information to screen out sub-optimal donors.

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