# Diabetes Endothelial Keratoplasty Study: Impact of Diabetes on Corneal Transplant Success and Cell Loss

> **NIH NIH UG1** · JAEB CENTER FOR HEALTH RESEARCH, INC. · 2021 · $831,294

## Abstract

PROJECT SUMMARY
 This proposal addresses a significant public health question: Does diabetes, the
3rd leading cause of death in the United States (US), impact suitability of donor corneal
tissue for transplantation? This question takes on increasing urgency as recent eye bank
data suggests donors with diabetes now comprise about 30-35% of the cornea donor
pool, a 50-72% increase in just over a decade. The impact of diabetes on keratoplasty
outcomes remains unknown, with conflicting evidence from secondary or retrospective
analyses of multiple clinical studies. Previous large clinical studies did not show a
diabetic donor effect on penetrating keratoplasty (PKP) and Descemet membrane
endothelial keratoplasty (DMEK) graft success, yet our recent Cornea Preservation Time
Study (CPTS) found the diabetic donor adversely affected graft outcomes following
Descemet stripping automated endothelial keratoplasty (DSAEK). Although current
standard of care is to use diabetic donor corneas for all types of keratoplasties, some
eye banks and surgeons are increasingly avoiding them for DMEK. As both the diabetic
donor population and DMEK demand increases, a definitive superiority study evaluating
effect of donor diabetes status on graft outcomes will allay and/or define these concerns.
The Diabetes Endothelial Keratoplasty Study (DEKS) will address these important
questions through a prospective masked clinical trial enrolling 1420 participant-eyes at
30 clinical sites and 15 eye banks across the US. The DEKS will determine if the 3-year
graft success rate following DMEK performed with corneas from donors without diabetes
is superior to the graft success rate with corneas from donors with diabetes. It will also
determine if the 3-year central endothelial cell loss (ECL) after DMEK with corneas from
donors without diabetes is less than the central ECL when corneas from donors with
diabetes are used. Lastly, the DEKS will explore the relationship of donor diabetes
severity, as measured by eye bank-determined diabetes risk categorization scores, post-
mortem HbA1c, and skin advanced glycation endproducts and oxidation markers, with
DMEK graft outcomes 3 years postoperatively in corneas from diabetic donors. The
DEKS could have a major impact on the targeted use of corneas from an increasing
number of donors with diabetes with a range of disease severity in a donor pool that
must continue to expand to meet the clinical demands of an aging population and DMEK
growth.

## Key facts

- **NIH application ID:** 9933642
- **Project number:** 1UG1EY030030-01A1
- **Recipient organization:** JAEB CENTER FOR HEALTH RESEARCH, INC.
- **Principal Investigator:** Colleen Bauza
- **Activity code:** UG1 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $831,294
- **Award type:** 1
- **Project period:** 2021-05-01 → 2026-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9933642

## Citation

> US National Institutes of Health, RePORTER application 9933642, Diabetes Endothelial Keratoplasty Study: Impact of Diabetes on Corneal Transplant Success and Cell Loss (1UG1EY030030-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9933642. Licensed CC0.

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