Age-Related Effects of Donor on Corneal Transplantation and Clinical Study of Causal Allograft Rejection in Pakistan

Authors

  • Muhammad Junaid Lincoln University College, Malaysia; Mehboob Charity Vision International Eye and General Hospital, Mansehra, Pakistan; Lincoln University College, Malaysia https://orcid.org/0009-0006-8747-0241
  • Azmat Kamran Saba Deseret International Eye Hospital, Baffa Khurd, Mansehra, Pakistan; Rawalpindi Eye Donor Organization (REDO), Rawalpindi, Pakistan
  • Suriyakala Perumal Lincoln University College, Malaysia
  • Irfan Ali Mehboob Charity Vision International Eye and General Hospital, Mansehra, Pakistan

DOI:

https://doi.org/10.61919/jhrr.v5i2.1748

Keywords:

Corneal transplantation, Donor age, Allograft rejection, Clinical outcomes

Abstract

Background: Corneal transplantation is a widely performed surgical procedure for treating corneal blindness. Donor-related factors, particularly age, are known to influence graft survival and rejection rates. While younger donor corneas exhibit higher endothelial cell density, their potential for increased immunogenicity remains a concern. This study evaluates the impact of donor age on corneal transplantation outcomes in Pakistan. Objective: To assess the influence of donor age on graft clarity, visual acuity, and allograft rejection rates following corneal transplantation. Methods: A retrospective observational study was conducted from February 2013 to June 2016 in collaboration with the Rawalpindi Eye Donor Organization, The Shifa Eye Trust, and Saba Deseret Eye Hospital. A total of 300 patients underwent corneal transplantation, categorized by donor age: <40 years (n=105), 40–60 years (n=120), and >60 years (n=75). Surgical techniques included Penetrating Keratoplasty (PK) (70%), Descemet’s Stripping Endothelial Keratoplasty (DSEK) (20%), and Descemet Membrane Endothelial Keratoplasty (DMEK) (10%). Postoperative outcomes were assessed at 12 months. Data were analyzed using SPSS v25, with chi-square tests for categorical variables and logistic regression for predictors of rejection. Results: At 12 months, 80% (n=240) of grafts remained clear, while 20% (n=60) developed opacity. Visual acuity improved to 20/40 or better in 85% (n=255) of patients. The overall rejection rate was 15% (n=45), highest in young donor grafts (21%), followed by middle-aged (13%) and older donor grafts (8%) (p=0.046). Patients undergoing DSEK and DMEK had significantly lower rejection rates than PK (p<0.01). Conclusion: Donor age did not significantly affect graft clarity or visual acuity but influenced rejection rates, with younger donor grafts exhibiting a higher risk. Advanced surgical techniques and postoperative steroid management improved outcomes. Future research should focus on optimizing donor selection criteria and long-term graft survival strategies.

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Author Biography

Muhammad Junaid, Lincoln University College, Malaysia; Mehboob Charity Vision International Eye and General Hospital, Mansehra, Pakistan; Lincoln University College, Malaysia

Executive Director Hospital/Chief Executive Officer, Mehboob Charity Vision International Eye and General Hospital Main Karakoram Highway, Gandhian Mansehra KPK, Pakistan

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Published

2025-02-28

How to Cite

Junaid, M., Kamran, A., Suriyakala Perumal, & Ali, I. (2025). Age-Related Effects of Donor on Corneal Transplantation and Clinical Study of Causal Allograft Rejection in Pakistan. Journal of Health and Rehabilitation Research, 5(2), 1–6. https://doi.org/10.61919/jhrr.v5i2.1748

Issue

Volume 5, Issue 2 (February 2025)

Section

Articles

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Copyright (c) 2025 Muhammad Junaid, Azmat Kamran, Suriyakala Perumal, Irfan Ali

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