PURPOSE To determine the influence of pre-operative donor tissue characteristics on the graft dislocation rate after Descemet’s stripping automated endothelial keratoplasty (DSAEK). METHODS We retrospectively analyzed associations between donor tissue characteristics and graft dislocation rates for consecutive DSAEK surgeries performed in a four year period at a single institution. RESULTS From June 2007 to June 2011, 64 (18%) of 355 eyes underwent a procedure for graft dislocation. There were no differences in donor age, pre-operative endothelial graft thickness, pre-processing endothelial cell density, change in endothelial cell density after processing, time from death to tissue processing, or time from tissue processing to surgery between eyes that experienced dislocations and those that did not (P>.05 for each). The graft recipient’s corneal disease diagnosis, pre-operative corneal thickness, pre-operative visual acuity, glaucoma status, history of glaucoma surgery, and cataract surgery at the time of DSAEK were not associated with an increased rate of dislocation (P>.05 for each). Recipients who experienced graft dislocation were significantly older (73.6 vs. 70.2 years, P=.03) and more likely to undergo subsequent repeat transplantation (29.7% vs. 10.7%, P<.0001). CONCLUSIONS We found no correlation between any corneal donor tissue characteristic and graft dislocation after DSAEK. Graft dislocation was more common in older recipients. Patients with dislocation had a higher rate of subsequent transplantation.

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