DONOR ORGAN-CULTURED CORNEAL TISSUE SELECTION BEFORE PENETRATING KERATOPLASTY

Aims-Donor organ cultured corneal tissue selection before penetrating keratoplasty is carried out by taking into account different variables . The objective was to identify preoperative variables which are signi ficantly and independently associated with transplant outcome and shou ld effectively be taken into account before transplantation. Methods-2 31 consecutive penetrating keratoplasties were prospectively studied c ultured tissue. Morphometric analysis of the donor corneal endothelium was performed before transplantation. Graft survival and endothelial cell density, during the second year following transplantation, were s tudied both at a univariate and multivariate level. Results-Recipient age, recipient rejection status, and preoperative diagnosis significan tly influenced graft survival. Graft survival was higher when using co rneal tissue from donors older than 80 years. Postoperative endothelia l density decreased with preservation time and coefficient of variatio n after preservation. It increased with endothelial cell density after preservation and deswelling time, and correlated with preoperative di agnosis. Conclusion-Organ cultured corneas with endothelial cell densi ty after preservation <2000 cells/mm(2), and high coefficient of varia tion, may be discarded before transplantation. Corneas should be prese rved for less than 3 weeks, and allowed to deswell before transplantat ion for 2 or 3 days rather than 1 day.