Vm. Borderie et al., DONOR ORGAN-CULTURED CORNEAL TISSUE SELECTION BEFORE PENETRATING KERATOPLASTY, British journal of ophthalmology, 82(4), 1998, pp. 382-388
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.