THE INFLUENCE OF THE CAUSE OF DEATH AND AGE ON HUMAN CORNEAL METABOLISM

Purpose. Little is known about the metabolic status of human corneas b efore transplantation. The authors attempted to determine the influenc e of both cause of death and age on the corneal metabolism. Methods. A denosine-triphosphate (ATP), adenosine-diphosphate (ADP), glucose, and lactate were measured in the stroma and endothelium of 30 human corne as. The corneas were divided into four groups according to cause of de ath and four groups according to age. Corneas from donors with diabete s were excluded. Results. Corneas from patients who died suddenly-beca use of cardiac infarction, for example-have good metabolic status even 24 hours after death. In corneas of patients with cancer or sepsis, t he metabolism has run down. In comparison, corneas from patients with cancer are in better metabolic condition than those from donors with s epsis because they have adapted to catabolism. Corneas donated from pa tients with renal insufficiency show results somewhere in between. Sta tistical evaluation revealed significant differences in ATP concentrat ions for corneas from donors who died suddenly and from patients with renal insufficiency compared to corneas from patients with sepsis. It could be shown that glucose concentrations as a resource for metabolis m increase with age. The best ATP-ADP ratios were found in the group o f 40- to 59-year-old donors. Nevertheless, differences between the age groups were not statistically significant.Conclusion. From our result s it can be concluded that the cause of death and systemic metabolism have an influence on corneal metabolism. Results concerning donor age reflect the well-known fact that donor age has no influence on the qua lity of keratoplasty material.