effect of graft rating on results following dalk

purpose: to evaluate the influence of donor characteristics (age, death-to-preservation time, preservation-to-surgery time, graft rating, and endothelial cell features) on clinical outcomes following deep anterior lamellar keratoplasty (dalk) in patients with keratoconus. methods: in this retrospective study, 290 consecutive keratoconic eyes underwent dalk using donor corneas of different qualities, ranging from fair to excellent. a multivariate regression analysis was used to assess the correlation between donor characteristics and postoperative outcomes. results: mean donor and recipient ages were 33.4±13.1 and 27.7±8.0 years, respectively. mean follow-up period was 38.2±20.2 months. the presence of epithelial defects on postoperative day 1 had a significant correlation with donor epithelial sloughing (r= 0.26, p< 0.001), preservation-to-surgery time (r= 0.21, p= 0.001), and graft rating (r= -0.17, p= 0.004). graft stromal edema on postoperative day 1 was significantly correlated with donor epithelial sloughing (r= 0.31, p< 0.001), preservation-to-surgery time (r= 0.24, p< 0.001), and graft rating (r= -0.28, p< 0.001). suture-related complications, graft rejection episodes, graft clarity, visual acuity, and refractive outcomes at the final follow-up examination were found to have no correlation with any donor factors. conclusion: the donor features had no influence on visual and refractive outcomes and complications.