Effect of Head Trauma–Related Deaths on Corneal Endothelial Cell Loss in Eye Bank Donors

Abstract

Purpose: The purpose of this study was to examine the effect of head trauma–related deaths on corneal endothelial cell density (ECD) in eye bank donors. Methods: This is a retrospective study of 287 corneas from donors with causes of death secondary to motor vehicle accident with sustained head trauma (n = 50), gunshot wound to the head (n = 138), fall with sustained head trauma (n = 2), and non-head–related traumatic causes of death (n = 97). Donors older than age 50 years were excluded due to concern for undiagnosed Fuchs endothelial dystrophy as a potential confounder for the cause of endothelial cell loss. Donor characteristics, ECD, and focal endothelial cell loss on specular microscopy were compared between the groups. Donors in the head trauma and nonhead trauma groups were matched by age; there were 42 age-matched donors in both groups. Results: Age and ECD were negatively correlated (Pearson correlation coefficient = −0.57). Death-to-preservation time was not significantly different between the 2 groups (P value = 0.59). The mean ECD in the head trauma group was 2859 ± 370 cells/mm2 and 3041 ± 464 cells/mm2 in the nonhead trauma group. The head trauma group had a lower ECD (178 ± 70 cells/mm2, P value = 0.013). After matching for age, the difference in ECD between the 2 groups was −94 ± 82 cells/mm2 (P value = 0.26). The adjusted odds of having focal endothelial cell loss was not statistically significant (P value = 0.50) between the groups. Conclusions: After statistical adjustments, there were no differences between the head trauma and nonhead trauma groups.