Increased endothelial cell loss after transplantation of corneas preserved by a modified organ-culture technique.
Forty-seven donor corneas were preserved in McCarey-Kaufman (M-K) medium at 4 degrees C for 1 day, then in organ culture at 34 degrees C for approximately 1 month, then in M-K medium at 4 degrees C for an additional two days before transplantation. The central donor endothelium was examined by specular microscopy before and after organ culture and 2 months after keratoplasty. No significant change in central endothelial cell density occurred during organ culture. The 47 transplants were compared with 47 grafts preserved only in M-K medium at 4 degrees C for approximately 36 hours. All transplants were performed by the same surgeon over the same period, and the two groups contained similar types of surgical procedures. The organ-cultured grafts were thicker on the first post-operative day and took longer to epithelialize . Two months after keratoplasty all of the 94 grafts were clear and thin, but the mean central endothelial cell loss was 28% in the 47 organ-cultured transplants and 10% in the 47 transplants preserved only in M-K medium (P less than 0.0001). These results indicate that the endothelium of corneas preserved by organ culture at 34 degrees C and then placed in M-K medium at 4 degrees C for 2 days may be more susceptible to surgical trauma than those preserved only in M-K medium at 4 degrees C.
D000293:Adolescent; D000328:Adult; D002452:Cell Count; D002648:Child; D003315:Cornea / Q000166:cytology; D016039:Corneal Transplantation; D004727:Endothelium / Q000166:cytology; D006801:Humans; D008853:Microscopy; D009924:Organ Culture Techniques / Q000379:methods*; D010781:Photography; D011182:Postoperative Care; D013997:Time Factors