Vision Science Research Seminar Series
Factors Related to Corneal Graft Success, Cell Loss and Rejection
Loretta Szczotka-Flynn OD, PhD
Department of Ophthalmology & Visual Sciences Case Western Reserve University, Cleveland, Ohio
Abstract: The Cornea Preservation Time Study (CPTS) was an NIH funded randomized clinical trial on the effects of corneal preservation time (PT) on graft success and endothelial cell loss after Descemet stripping automated endothelial keratoplasty (DSAEK) involving 1330 donor corneas, 70 surgeons, 40 sites and 23 eye banks in the US. Prior to initiation of the trial in 2012, there was a general consensus among corneal surgeons and eye banks in the United States, centered largely around habit and unsubstantiated beliefs, that donor corneal tissue preserved for more than 7 days was inferior to tissue preserved for shorter time for domestic PKP and/or endothelial keratoplasty (EK). This practice was prevalent despite United States Food and Drug Administration (FDA) approval of 4-8˚C storage solutions for up to 14 days. The study has published its primary results in 2017 and has additionally yielded much more data that are being used to address these and many other associations with endothelial keratoplasty outcomes. This talk will present the primary outcome results as well as many other factors associated with graft success, cell loss and rejection from the CPTS trial, but also data from other NIH funded corneal transplant studies. Finally, the impact of cell loss after transplant will discussed in its relevance to post-surgical contact lens fitting.
Biography: Dr. Szczotka-Flynn is a Professor of Ophthalmology and Visual Sciences at Case Western Reserve University (CWRU) where she has been on faculty for 26 years with experience in the treatment and research of corneal diseases, and Director of the Contact Lens Service at University Hospitals of Cleveland. She completed dual OD/MS degrees at The Ohio State University College of Optometry in 1992 and a Ph.D. degree in Epidemiology in 2010. Her research experience includes many single and multi-centered trials, personally recruiting over 700 subjects in the past 10 years across multiple contact lens trials, over 200 participants for keratoconus studies, and she directs the NEI funded Coordinating Center for the Cornea Preservation Time Study, which completed enrollment of 1330 eyes for endothelial keratoplasty across 40 sites in the US. She serves in many leadership positions within the field of cornea and contact lenses, including serving as a reviewer or consultant to the FDA and NEI multiple times and as immediate past Chair of the Cornea, Contact Lens and Refractive Technology Section of the American Academy of Optometry. Lastly, as Director of the Vision Research Coordinating Center within the Department of Ophthalmology & Visual Sciences at CWRU, she interfaces with multiple clinical trials, and clinical and basic science investigators across the breadth of ophthalmology.
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