Purpose: The authors evaluated the changes in donor endothelial cell density (ECD) caused by the precutting and long-distance transportation of corneal grafts for Descemet stripping automated endothelial keratoplasty (DSAEK) from overseas eye banks.
Methods: A total of 124 consecutive precut donor tissues for DSAEK were obtained from overseas eye banks. The ECD was examined before precutting, after precutting, and after overseas transportation. Changes in ECD secondary to the precutting procedure and after long-distance transportation were evaluated.
Results: The average ECD before and after precutting was 2637 ± 336 and 2578 ± 305, respectively (P = 0.0063). The ECD after overseas transportation was 2468 ± 272, which is a significant decrease compared with the ECD after the precutting procedure (P < 0.001). The average rate of ECD loss was 1.75% for precutting and 3.79% for overseas transportation, with a total ECD loss of 5.68%. The ECD before surgery was >2000 cells per square millimeter in all cases, and all grafts were available for DSAEK.
Conclusions: Imported precut donor corneas form overseas eye banks are a valuable source of donor corneas for DSAEK. The cell loss associated with precutting and the overseas transportation of corneal grafts on donor endothelial cell loss is acceptable.