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Gender matters when it comes to corneal transplants

9 September 2016

Doctors who transplant corneas have always thought of the vision-saving surgery as gender-neutral, but a new study in the U.K. has found that female patients do better if they get their new corneas from other women rather than men.

The study of more than 18,000 patients in the U.K. found that female transplant recipients were more likely to have successful transplants if they got a woman’s cornea—but there was no gender difference in failure rates for men receiving women’s tissue. With one corneal disease, called Fuchs endothelial dystrophy, women’s transplants were 40 percent less likely to fail if they received another woman’s cornea instead of a man’s, according to the study published Thursday in the American Journal of Transplantation.

Christopher J. Rapuano, who heads the cornea service at the Wills Eye Hospital in Philadelphia and was not involved in the research, says he was surprised to see gender turn up as such a significant factor. “It seems like something that we would have known about before,” he says.

The cornea is the front part of the eye that gives it its curvature and two thirds of its refracting power. Injury, infection or disease can damage the cornea, limiting vision and potentially leading to blindness. Surgeons perform about 45,000 to 50,000 corneal transplants a year in the U.S.

Previous research has not indicated the need to separate transplants by gender. “In Australia, we do not see—have never seen—an influence of gender matching or mismatching on corneal graft outcome,” Keryn Williams, scientific director of the Australian Corneal Graft Registry who was not involved in the research, wrote in an e-mail. Williams speculated that the results could be at least partly due to the fact that donors and patients in the U.K. are matched differently than they are in many other parts of the world.



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