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Older Corneas are Suitable for Transplantation, Study Shows

Results could significantly expand donor pool, allow more patients to be helped

Wednesday, April 09, 2008

Patients and surgeons at the University of Rochester Eye Institute participated in a study indicating that corneal transplants using tissue from older donors have similar rates of survival to those using tissue from younger donors.

The five-year transplant success rate for recipients was the same – 86 percent – for transplants performed across the nation with corneas from donors age 12 to 65 years and from donors age 66 to 75. Because of this new finding, the donor age pool – currently limited to donors 65 and younger –should be expanded to include donors up to 75 years of age, according to a study funded by the National Eye Institute of the National Institutes of Health and published in the April issue of Ophthalmology.

The availability of donor corneas has been adequate for the past 10 years in the United States, where more than 33,000 corneal transplants are performed each year. However, recent changes in Food and Drug Administration regulations will likely cause a decrease in the supply of donated corneas. These new regulations require additional screening and testing of potential donors for contagious diseases, registration of eye banks, more detailed records and labels, and stricter quarantine procedures. In addition, many eye banks previously set the age limit for donors at 65 years or younger because some surgeons have been reluctant to use older corneas. The findings from the new study could lessen these restrictive age policies.

“This pivotal study indicates that corneas from older individuals are just as successful when used for transplants as those from younger donors,” said corneal specialist Steven Ching, M.D., professor of Ophthalmology at the University of Rochester Eye Institute and medical director of the Rochester Eye and Tissue Bank. “These study results will expand the donor cornea pool and allow more patients to be helped.”

The University of Rochester Eye Institute is one of 80 sites that participated in the Cornea Donor Study and helped bring together more than 1,101 participants and 105 surgeons from across the United States. Twelve participants from the University of Rochester Eye Institute were between 40 and 80 years of age and were chosen for the study if they were in need of a corneal transplant for a corneal disease that put them at moderate risk for clouding of the transplanted cornea. After the transplant surgery, the participants were followed for five years. The transplant was considered a failure if a repeat corneal transplant was required or if the cornea was cloudy for at least three months. Donor corneas were provided by 43 participating eye banks, including the Rochester Eye and Tissue Bank, a nonprofit agency independent from the University of Rochester. All donor corneas met Eye Bank Association of America standards for human corneal transplantation and were consistent with eye banks’ tissue ratings of good to excellent quality.

“The pressure on eye banks to provide corneas is increasing,” Ching said. “The results of this study will expand the available donor pool and should persuade surgeons to use corneas from older donors. These changes will greatly benefit the growing number of individuals who need corneal transplants.”

Additional support for the Cornea Donor Study was provided by Eye Bank Association of America, Bausch & Lomb Inc., Tissue Banks International, Vision Share Inc., San Diego Eye Bank, The Cornea Society, Katena Products Inc., ViroMed Laboratories Inc., Midwest Eye-Banks (Michigan Eye-Bank, Illinois Eye-Bank), Konan Medical Corporation, Eye Bank for Sight Restoration, SightLife, Sight Society of Northeastern New York (Lions Eye Bank of Albany), and Lions Eye Bank of Oregon.

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Karin Christensen

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