Gender Matching Did Not Affect 2-year Rejection or Failure Rates Following DSAEK for Fuchs Endothelial Corneal Dystrophy

purpose: to investigate whether 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).DESIGN: clinical cohort study.methods: sthis study used a multi-center registry including patients aged > 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.results: 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 = .12, P = .06) or failure ( P = .28, P = .14), respectively.conclusions: in patients with FECD undergoing DSAEK, no significant influence of gender and or H-ymismatch on graft rejection or failure was found.