Preparation of Donor Descemet Membrane Endothelial Keratoplasty Tissue Under Age 50 Compares Favorably With Older Tissue

Purpose: Corneal tissue shortage is an ongoing concern for corneal surgeons and eye banks across the United States. Descemet membrane endothelial keratoplasty (DMEK) procedure numbers surpassed Descemet stripping automated endothelial keratoplasty in 2023, leading to an increased demand that has been met with limited DMEK tissue availability. In response to the growing demand, our goal is to compare and characterize feasibility of DMEK tissue from donors younger than 50 and donors 50 and older, including DMEK tissue processing times, preprocessing endothelial cell counts, and processing success rate. Methods: Retrospective review of donor corneas used for DMEK tissue processing from 2018 to 2024 at a single eye bank with a post hoc analysis. Results: A total of 8915 cornea samples were used for transplantation during study period. Preprocessing endothelial cell counts were not significantly different between donor group age 50 or older or donor group younger than 50. Postprocessing endothelial cell counts were higher for donor group under 50. There was no statistically significant difference in processing times between donors 50 or older or younger than 50. Tissue peel difficulty was significantly reduced in donors younger than 50 compared to donors 50 or older. Conclusions: Preprocessing endothelial cell counts were similar between both age groups with higher postprocessing endothelial cell counts in donors younger than 50. Tissue processing time and tissue processing failure rate were also similar between the 2 age groups while tissue from donors less than 50 was easier to peel. This highlights that younger donors are a viable pool for DMEK tissue, which could help address the ongoing tissue shortage.