Diabetes Research Uncovers Insights on Cornea Donor Diabetes Effect on Endothelial Cell Density and Morphometry

Strategic Insights -

New research from Case Western Reserve University has shed light on the relationship between cornea donor diabetes and endothelial cell density and morphometry after Descemet membrane endothelial keratoplasty (DMEK) surgery. The study, conducted from February 2022 to July 2024, analyzed the effects of cornea donor diabetes on endothelial cell loss and morphometric changes 1 year after successful DMEK. The study found that endothelial cell loss and morphometry 1 year after DMEK were not affected by cornea donor diabetes status.

Key Takeaways:

  • The study, which analyzed 1274 eyes of 982 recipients, found no significant difference in endothelial cell density (ECD) at 1 year between the two groups of eyes (1927 (498) cells/mm2 and 1920 (496) cells/mm2, respectively).
  • The study found that mean (SD) CV (31.5% [4.1%] vs 31.4% [4.1%]) and mean (SD) HEX (57.7% [5.8%] vs 57.2% [5.8%]) did not differ at 1 year between the two groups of eyes.
  • The study concluded that endothelial cell loss and morphometry 1 year after DMEK were not affected by cornea donor diabetes status, supporting the use of corneas from donors with diabetes for endothelial keratoplasty procedures.
  • The study utilized a multicenter, double-masked, randomized clinical trial design, conducting the trial at 28 US clinical sites and 13 eye banks.
  • The study included eyes of recipients who underwent successful DMEK, primarily for Fuchs endothelial corneal dystrophy, and had at least 1 analyzable postoperative endothelial image.
  • The study's findings have the potential to inform clinical practice and improve outcomes for patients undergoing DMEK surgery.

Statistics:

  • 1274 eyes of 982 recipients were included in the study.
  • The mean age of the recipients was 70 (8) years, with 569 female (57.9%) and 816 (64.1%) having tissue from donors without diabetes and 458 (35.9%) with tissue from donors with diabetes.
  • Mean (SD) central ECD in tissue from donors without diabetes and with diabetes were 2676 (290) cells/mm2 and 2671 (286) cells/mm2, respectively.
  • Mean (SD) 1-year ECD were 1927 (498) cells/mm2 and 1920 (496) cells/mm2, respectively.
  • Mean (SD) CV did not differ at 1 year between the two groups of eyes (31.5% [4.1%] vs 31.4% [4.1%]).
  • Mean (SD) HEX did not differ at 1 year between the two groups of eyes (57.7% [5.8%] vs 57.2% [5.8%]).

Sources:

  • "Endothelial Cell Loss 1 Year After Successful DMEK in the Diabetes Endothelial Keratoplasty Study: A Randomized Clinical Trial." JAMA Ophthalmology, 2025.
  • "Studies from Case Western Reserve University Update Current Data on Diabetes Research (Endothelial Cell Loss 1 Year After Successful DMEK in the Diabetes Endothelial Keratoplasty Study: A Randomized Clinical Trial)." Clinical Trials Week. October 27, 2025; p 610.
  • ClinicalTrials.gov Identifier: NCT05134480.