Comparison of in situ excision and whole-globe recovery of corneal tissue in a large, single eye bank series.
OBJECTIVE
To compare the quality of corneal tissue after 2 different procurement techniques, whole-globe enucleation and in situ excision.


METHODS
Cross-sectional study.


METHODS
Data in the interval 2005 to 2008 were collected from the Lions Eye Bank of Oregon. A total of 3618 eyes underwent whole-globe enucleation (enucleation group) and 2048 eyes were subject to in situ excision (in situ group). Endothelial cell density (ECD) and death-to-preservation time (D-to-P) were analyzed. Grading scores ranging from 0 (excellent) to 4 (unacceptable for transplantation) were used to evaluate the epithelium, stroma, Descemet fold, and overall endothelium. The incidences of ECD less than 2000 cells/mm(2) (ECD <2000), primary graft failure (PGF), and postoperative infection were investigated.


RESULTS
ECD was 2726 +/- 419 cells/mm(2) in the enucleation and 2645 +/- 395 cells/mm(2) in the in situ group (P < .001). D-to-P was 9.81 +/- 3.56 hours and 8.90 +/- 3.65 hours, respectively (P < .001). The mean grade of the stroma was 1.44 +/- 0.51 in the enucleation group and 1.50 +/- 0.56 in the in situ group (P = .001). The mean grades of overall endothelium were 1.51 +/- 0.72 and 1.58 +/- 0.69, respectively (P < .001). The incidence of ECD <2000 was 2.38% in the enucleation group and 2.39% in the in situ group (P > .999), PGF rates were 0.72% and 0.68% (P > .999), and postoperative infection levels were 0.14% and 0.39% (P = .080).


CONCLUSIONS
Although there were minor differences in parameters related to the endothelium, in situ excision seemed equivalent to whole-globe enucleation when various parameters were evaluated.
Kim
Jae-Hyung
JH
Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Kim
Myoung Joon
MJ
Stoeger
Christopher
C
Clover
Jameson
J
Kim
Jae Yong
JY
Tchah
Hungwon
H
D002452:Cell Count; D002809:Chondroitin Sulfates; D045424:Complex Mixtures; D003315:Cornea; D016039:Corneal Transplantation; D003430:Cross-Sectional Studies; D015925:Cryopreservation; D003911:Dextrans; D004728:Endothelium, Corneal / Q000473:pathology; D005125:Eye Banks / Q000379:methods*; D015353:Eye Enucleation; D005839:Gentamicins; D006085:Graft Survival; D006801:Humans; D008875:Middle Aged; D009926:Organ Preservation; D019188:Organ Preservation Solutions; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting / Q000379:methods*; D009927:Tissue and Organ Procurement
D045424:Complex Mixtures; D003911:Dextrans; D005839:Gentamicins; D019188:Organ Preservation Solutions; D002809:Chondroitin Sulfates; C075736:Optisol