CORNEOSCLERAL DISCS EXCISED FROM ENUCLEATED AND NON-ENUCLEATED EYES ARE EQUALLY SUITABLE FOR TRANSPLANTATION

Purpose: To assess whether the biological quality of corneoscleral tis sue dissected in situ is, after organ culture, comparable to that harv ested after enucleation. Methods: Corneoscleral discs were prepared fr om 23 donor eyes, either after enucleation, under laminar pow conditio ns (right eyes; group 1) or by direct excision in situ (left eyes; gro up 2), Endothelial cell counts were made and the degree of tissue cont amination assessed both prior to and upon termination of organ culture . Results: Microbial growth was found in 12/22 conjunctival swabs coll ected from group 1 eyes and in 14/22 of those obtained from group 2 gl obes (p = 0.76), Bacterial growth was detected in four primary culture media, two horn each group, at low colony densities, No significant d ifference in endothelial cell counts were encountered between the two groups, either immediately after dissection [group 1: 2940 +/- 308 (21 00-3500) c/mm(2); group 2: 2947 +/- 345 (2200-3700) c/mm(2); p=0.945] or upon termination of organ culture [group 1: 2646 +/- 321 (1895-3200 ); group 2: 2723 +/- 312 (2100-3650); p = 0.413]. Conclusion: Dissecti on of corneoscleral discs in situ may serve as an alternative to the c onventional technique if consent is obtained to remove only the cornea . The risk of contamination is no higher and endothelial cell viabilit y no lower than in tissue derived from enucleated globes, provided tha t the excision is performed by a skilled surgeon and a rigorous disinf ection protocol is instigated.