ENDOTHELIAL VIABILITY OF ORGAN-CULTURED CORNEAS FOLLOWING PENETRATINGKERATOPLASTY

Purpose To assess endothelial integrity following corneal transplantat ion using human corneas stored in organ culture in the Manchester Eye Bank. Methods A prospective study was undertaken on 24 patients who ha d received full-thickness corneal grafts using corneas stored in organ culture. The donor corneal endothelium was photographed prior to tran splantation using light microscopy. Specular microscopy and ultrasonic pachometry were performed at 30 days (+/- 3 days), 12 weeks (+/- 1 we ek), 26 weeks (+/- 2 weeks) and 52 weeks (+/- 4 weeks) following corne al transplantation. The following cell parameters were measured: densi ty, area, coefficient of variation (CV) for area, perimeter, diameter, form factor and corneal thickness. Results One year after corneal tra nsplantation there was a statistically significant decrease in endothe lial cell density (-39.4%), and a statistically significant increase i n endothelial cell area (+94.4%), perimeter (+36.1%), diameter (+57.1% ) and form factor (+5.8%). However, no significant changes were seen i n CV or corneal thickness with respect to time after transplantation. (There were no significant changes in endothelial fell parameters and corneal thickness for 12 control subjects,) Conclusions Endothelial ce ll loss occurs at an accelerated rate from corneal transplants. This h ighlights the need for improving corneal endothelial viability during and after storage in order to improve the chances of longer-term survi val of the transplanted cornea.