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.
Division of Ophthalmology, Case Western Reserve University, Cleveland, OH.
J H
JH
Lass
W J
WJ
Reinhart
D L
DL
Skelnik
W E
WE
Bruner
R P
RP
Shockley
J Y
JY
Park
D L
DL
Hom
R L
RL
Lindstrom
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