title: Transplantation failure due to inadvertent reversal of human donor corneas.
abstract: OBJECTIVE
  To emphasize and create awareness of the possibility of inadvertently grafting an inverted corneal button and describe 4 cases that showed this phenomenon on human donor corneas during preservation and transportation from an eye bank.
  
  
  METHODS
  Three out of 4 tissues showed inadvertent inversion during transportation and 1 was identified as inverted during preservation in the eye bank. Out of the 3 tissues that were shipped, 2 tissues were transplanted and 1 was identified as inverted prior to transplantation and shipped back to the eye bank.
  
  
  RESULTS
  Four tissues showed inversion at different time points. The anatomy was clearly visible with a naked eye that showed the presence of trabecular meshwork on its outside along with some residual choroid. The endothelial cell count was in the range of transplantation without any mortality even after inversion. The inverted corneas showed a mountain-like shape with grooves as compared to the normal cornea.
  
  
  CONCLUSIONS
  Previous reports have identified tissue inversion post-transplantation. We describe inadvertent inversion of donor tissues during preservation and transportation from an eye bank. It is recommended to check the presence of corneo-scleral rim, trabecular meshwork, grooves, and residues of choroid if present inside or outside before transplantation to ensure accurate grafting and avoid transplantation failures.
authors.affiliation: International Center for Ocular Physiopathology (ICOP), Fondazione Banca Degli Occhi Del Veneto Onlus, Venice - Italy.
authors.forename: Mohit
authors.initials: M
authors.lastname: Parekh
authors.affiliation: International Center for Ocular Physiopathology (ICOP), Fondazione Banca Degli Occhi Del Veneto Onlus, Venice - Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ruzza
authors.affiliation: International Center for Ocular Physiopathology (ICOP), Fondazione Banca Degli Occhi Del Veneto Onlus, Venice - Italy.
authors.forename: Hossein
authors.initials: H
authors.lastname: Elbadawy
authors.affiliation: International Center for Ocular Physiopathology (ICOP), Fondazione Banca Degli Occhi Del Veneto Onlus, Venice - Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Ferrari
authors.affiliation: International Center for Ocular Physiopathology (ICOP), Fondazione Banca Degli Occhi Del Veneto Onlus, Venice - Italy.
authors.forename: Gianni
authors.initials: G
authors.lastname: Salvalaio
authors.affiliation: International Center for Ocular Physiopathology (ICOP), Fondazione Banca Degli Occhi Del Veneto Onlus, Venice - Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Camposampiero
authors.affiliation: International Center for Ocular Physiopathology (ICOP), Fondazione Banca Degli Occhi Del Veneto Onlus, Venice - Italy.
authors.forename: Diego
authors.initials: D
authors.lastname: Ponzin
mesh_terms: D000328:Adult; D000368:Aged; D003316:Corneal Diseases / Q000601:surgery; D005125:Eye Banks; D005260:Female; D006084:Graft Rejection / Q000209:etiology* / Q000601:surgery; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000009:adverse effects*; D008297:Male; D019300:Medical Errors / Q000009:adverse effects*; D009926:Organ Preservation / Q000009:adverse effects*; D012086:Reoperation; D014019:Tissue Donors; D009927:Tissue and Organ Procurement; D014186:Transportation; D017211:Treatment Failure