Purpose To evaluate the clinical results of corneal transplantations u
sing organ-cultured donor corneas. Material and methods We retrospecti
vely studied our 50 first penetrating keratoplasties performed with co
rneas organ-cultured ibr 2 to 5 weeks at + 31 degrees C (Inosol(R) med
ium, Opsia). The average follow-up is 11.6 months. The main indication
s for grafting were bullous keratopathy (56 %) and keratoconus (26 %).
Results At 1 year the graft survival rate was 81 %. The causes of gra
ft failure were immune rejection (n = 3), non immune secondary endothe
lial decompensation (n = 3) and uncontrolled glaucoma (n = 1). The ave
rage endothelial density during the second year was 1 349 cell/mm(2).
It was 1 852 in the group of keratoconus and 751 in the group of bullo
us keratopathy. The average corrected visual acuity was 20/66 at 12 mo
nths. it was 20/45 in the group of keratoconus and 20/125 in the group
of bullous keratopathy. The average astigmatism was 4.9 D, but runnin
g suture was still present al 12 months in most patients. Compared wit
h graft survival after storage at + 4 degrees C (retrospective paired
control group), graft survival was higher after organ culture, but the
difference does nor reach the statistical significant threshold (p =
0.07). Conclusions Organ culture is able to ensure the quality of corn
eal endothelium and then avoids non immune primary graft failure.