Does Storage Time Affect the Outcomes of Split Corneal Transplantation to Reduce Corneal Donor Shortage? A Retrospective Study

Split cornea transplantation can reduce the shortage of donor corneas. Therefore, this study aimed to evaluate the effect of split graft storage time on the outcomes of split corneal transplantation through Descemet membrane endothelial keratoplasty (DMEK) and deep anterior lamellar keratoplasty (DALK) surgeries. Split corneal transplantation was performed in 80 eyes using 41 donor corneas. The mean before and after splitting storage times and total storage times were recorded. Donor corneal buttons and split grafts were stored in short-term solution at 4°C. In both surgeries (DMEK and DALK), donor corneas were divided into groups depending on their storage times. Mean postoperative 12th month best corrected visual acuity (BCVA), endothelial cell density (ECD), endothelial cell loss (ECL), central corneal thickness (CCT), refractive spherical equivalent (RSE), refractive astigmatism, and complication rates were compared among the groups. Correlation between storage times and 1-year BCVA, ECL, and complication rates were assessed. Clinical outcomes of the groups 1 year after the surgeries were also compared. DALK and DMEK were performed in 41 and 39 eyes, respectively. Storage times were not correlated with 1-year DMEK outcomes and only weakly correlated with post-DALK ECD, ECL, and RSE values. Except for CCT in those that underwent DALK, the outcomes of DMEK and DALK surgeries with stored and non-stored split grafts were not significantly different (P = .02). The storage times of donor corneas and split grafts do not have any impact on outcomes.