With better survival and lower rejection rates, anterior lamellar keratoplasty (ALK) has gained popularity as an alternative to penetrating keratoplasty to treat corneal stromal diseases. Because of this, researchers from Singapore evaluated the common protocol of donor/recipient age- and sex-matching on the outcomes of eyes that had undergone ALK surgeries. They presented their data this week at ARVO’s virtual 202 conference.

A total of 359 eyes from 322 patients who had ALK surgeries over an 11-year period were identified using graft registry data. To analyze the effects of sex-matching, transplants were classified as ‘presumed incompatible’ (male donor to female recipient) or ‘presumed compatible’ (all other donor to recipient sex combinations). For age-matching, differences in donor and recipient ages were calculated.

Records show that 246 grafts were presumed compatible, 14 grafts failed and eight were rejected. There were trends of lower hazard ratios in graft failure and rejection in the presumed compatible group.

The study found that sex- or age-matching had no significant effect on ALK transplant rejection and failure. “Although we demonstrated trends of lower risks of graft rejection and failure in sex-matched transplants, the number of ALK surgeries performed that would be required to show such differences would be too large for any study to obtain,” the authors explained in their ARVO abstract. “Without strong evidence, the routine practice of sex- and age-matching of donors and recipients during graft allocation for ALK surgeries thus cannot be recommended.”

Ong HS, Chiam N, Htoon HM, et al. The effects of Donor-Recipient Age and Sex Compatibility in the Outcomes of Anterior Lamellar Keratoplasties. ARVO Meeting 2021.