Influence of Lamellar Keratoplasty on donor trends and eye banking: A longitudinal review from a Turkish tertiary eye bank

PURPOSE: This study aimed to evaluate trends in the procurement, preservation, and utilization of corneal tissues at a tertiary eye bank in Turkey over a 7-year period.
METHODS: A retrospective review of eye bank records was conducted from January 2017 to December 2023. Variables analyzed included donor demographics (age, gender), cause of death, death-to-preservation interval (DPI), voluntary organ donor status, serological test results, preservation-to-utilization interval (PUI), endothelial cell density, donor tissue source, reasons for corneal discards, contamination status, indications for keratoplasty, usage rate of full-thickness vs. split grafts, keratoplasty types, and annual keratoplasty trends.
RESULTS: A total of 775 donors (69% male) and 1342 corneal grafts were analyzed. The mean donor age was 51.35±13.80 years, with the majority aged between 50 and 69 years. Only 5.4% of donors had voluntarily pledged organ donation. Serological screening was negative in 99.2% of cases. The mean DPI was 4.74±2.67 h, and the mean PUI was 4.64 days. The overall corneal utilization rate was 95.5%. Over the study period, the proportion of lamellar keratoplasty increased significantly, while penetrating keratoplasty declined. Logistic regression analysis demonstrated that calendar year was significantly associated with increased use of lamellar keratoplasty (odds ratio: 1.18, 95% confidence interval: 1.11–1.25; p<0.001). Approximately 30% of donor corneas were used in a split manner. The most common indications for transplantation were graft failure, corneal scarring, keratoconus, and bullous keratopathy.
CONCLUSION: The low rate of voluntary cornea donation and the limited utilization of split graft techniques highlight important areas for improvement and underscore the need for strategies to enhance donor awareness and optimize tissue utilization.

Keywords: Corneal donation, Corneal transplantation, Eye bank, Keratoplasty