An in vitro and clinical comparison of corneal storage with chondroitin sulfate corneal storage medium with and without dextran.
The safety and efficacy of 1% dextran in Chondroitin Sulfate Corneal Storage Medium (CSM) in reducing corneal swelling after 4 degrees C storage was assessed in a corneal endothelial cell culture system. No difference was found in 3H-thymidine incorporation by cells incubated in either CSM-dextran medium or CSM medium alone. Subsequently, 21 pairs of corneas, stored in either CSM or CSM-dextran from 30 to 112 hours, were transplanted into 42 eyes of 42 patients, paired by diagnostic group and procedure. All CSM grafts and 19 of 21 CSM-dextran grafts were clear at 4 months with no primary donor failures in either group. Intraoperative corneal thickness was significantly greater in the CSM group (0.82 +/- 0.07 mm) than the CSM-dextran group (0.76 +/- 0.06 mm); however, the two groups did not differ thereafter. No differences in all endothelial morphometric parameters were noted between the two groups pre- and postoperatively. Average endothelial cell loss by 4 months was 13.0 +/- 16.4% for the CSM group and 16.4 +/- 15.5% for the CSM-dextran group. The addition of dextran to CSM medium results in significant intraoperative corneal thinning without adversely affecting endothelial DNA synthesis in vitro and endothelial survival in vivo.
Lass
J H
JH
Division of Ophthalmology, Case Western Reserve University, Cleveland, OH.
Reinhart
W J
WJ
Skelnik
D L
DL
Bruner
W E
WE
Shockley
R P
RP
Park
J Y
JY
Hom
D L
DL
Lindstrom
R L
RL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002807:Chondroitin / Q000031:analogs & derivatives*; D002809:Chondroitin Sulfates / Q000494:pharmacology*; D003315:Cornea / Q000187:drug effects* / Q000201:enzymology; D016039:Corneal Transplantation; D003470:Culture Media; D004247:DNA / Q000096:biosynthesis / Q000187:drug effects; D003911:Dextrans / Q000494:pharmacology*; D004311:Double-Blind Method; D006085:Graft Survival; D006801:Humans; D008875:Middle Aged; D009113:Muramidase / Q000378:metabolism; D016032:Randomized Controlled Trials as Topic; D012044:Regression Analysis; D014021:Tissue Preservation / Q000379:methods*
D003470:Culture Media; D003911:Dextrans; D002807:Chondroitin; D002809:Chondroitin Sulfates; D004247:DNA; D009113:Muramidase