IN-SITU CORNEAL EXCISION - EXPERIENCE OF THE LIONS-CORNEA-BANK-OF-NORDRHEIN-WESTFALEN IN 1995 AND 1996

Background: Donor corneas are normally obtained by whole globe enuclea tion - a procedure often refused by the bereaved. To increase the acce ptance of cornea donation, we have exclusively obtained donor corneas by in situ excision since the end of 1994. There have been reports of increased endothelial damage and higher contamination rates. We report our experience in 1995 and 1996. Methods: The in situ excision was pe rformed by staff trained in microsurgical techniques. Only donor corne as with negative end-storage cultures after at least 10 days and an en dothelial cell count of more than 2500 cells/mm(2) were used for trans plantation. Results: In all, 705 corneoscleral buttons were excised fr om 1/95 to 12/96. The bereaved consented in 34 % in 1996. A total of 3 0.5 % of the corneas were ineligible for transplantation which corresp onds to the discard figures from all cornea banks with culture methods . We did not observe any primary transplant failure nor endophthalmiti s after 444 perforating keratoplasties. Conclusion: In situ corneal ex cision is safe, and helps to reduce the shortage in donor corneas.