Donor organ cultured corneal tissue selection before penetrating keratoplasty.
OBJECTIVE
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 significantly and independently associated with transplant outcome and should effectively be taken into account before transplantation.


METHODS
231 consecutive penetrating keratoplasties were prospectively studied using organ cultured 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 studied both at a univariate and multivariate level.


RESULTS
Recipient age, recipient rejection status, and preoperative diagnosis significantly influenced graft survival. Graft survival was higher when using corneal tissue from donors older than 80 years. Postoperative endothelial density decreased with preservation time and coefficient of variation after preservation. It increased with endothelial cell density after preservation and deswelling time, and correlated with preoperative diagnosis.


CONCLUSIONS
Organ cultured corneas with endothelial cell density after preservation < 2000 cells/mm2, and high coefficient of variation, may be discarded before transplantation. Corneas should be preserved for less than 3 weeks, and allowed to deswell before transplantation for 2 or 3 days rather than 1 day.
Borderie
V M
VM
Banque de cornées Saint Antoine, ETS de l'APHP, Hôpital Saint Antoine, Paris, France.
Scheer
S
S
Touzeau
O
O
Vedie
F
F
Carvajal-Gonzalez
S
S
Laroche
L
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002452:Cell Count; D002648:Child; D046508:Culture Techniques; D004728:Endothelium, Corneal / Q000166:cytology; D006085:Graft Survival; D006801:Humans; D015948:Keratoplasty, Penetrating; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D019737:Transplants