Gender matching did not affect 2-year rejection or failure rates following DSAEK for Fuchs endothelial corneal dystrophy

To investigate if donor to recipient gender or H-Y mismatching was associated with graft rejection or failure following Descemet stripping automated endothelial keratoplasty (DSAEK) in patients with Fuchs endothelial corneal dystrophy (FECD). Clinical Cohort study. We used multi-center registry including patients older than 18 years who had undergone their first DSAEK for FECD between January 2008 and March 2018. The impact of donor and recipient gender incompatibility (including H-Y mismatches) on corneal graft rejection and failure was evaluated using Kaplan-Meier curves and univariable and multivariable Cox models. Outcome data from 4341 eyes (3915 from the UK and 426 from Italy) were analyzed. Graft failure at 2-year follow-up occurred in 477 (11.0%) cases. Graft rejection at 2-year follow-up occurred in 175 cases (4.0%); 58 (1.3%) of whom developed graft failure. There was no significant effect of gender or H-Y mismatching on either rejection (p=0.12, p=0.06) or failure (p=0.28, p=0.14), respectively. In patients with FECD undergoing DSAEK, we found no significant influence of gender and or H-Y mismatch on graft rejection or failure.