Purpose: To compare the endothelial cell density (ECD) and quality of corneal grafts from young donors who sustained airbag deployment in motor vehicle accidents (MVA) or gunshot wounds (GSW) to the head with grafts from donors of similar age who died of other causes.
Methods: This is a retrospective comparative series of 65 corneal grafts from 33 young donors (mean age, 29.60 ± 8.95 yrs), with the cause of death either MVA with airbag deployment (n = 7), GSW to the head (n = 14), or other nontrauma-related cause (n = 12). Donor characteristics, graft quality on slit-lamp examination, ECD, and areas of endothelial cell loss on specular microscopy were compared between the groups.
Results: Donor age, graft quality on slit-lamp examination, and death-to-preservation time were similar between the groups. Statistically significant differences in focal areas of endothelial cell loss were found in the MVA- and GSW-derived grafts compared with the nontrauma-related grafts (85.7% vs. 0%, P value 0.0002 and 92.5% vs. 0%, P value <0.0001, respectively). Mean ECD was significantly lower in the 14 MVA-derived grafts (ECD, 3117 ± 218 cells/mm) and in the 27 GSW-derived grafts (ECD, 3234 ± 381 cells/mm) than in the 24 nontrauma-related grafts (ECD, 3511 ± 312 cells/mm, P values 0.0002 and 0.0068, respectively). No primary graft failures were reported for any of the grafts by masked observers.
Conclusions: MVA- and GSW-derived grafts have lower ECD counts and more areas of endothelial cell loss compared with nontrauma-related grafts. Further studies are needed to evaluate long-term outcomes of such donor grafts.