Corneal transplantation using 4-week banked donor material. Long-term results

Area of Science:

• Ophthalmology
• Transplantation Biology
• Biomaterials Science

Background:

• Corneal transplantation is a common procedure to restore vision.
• The availability of donor corneas is a limiting factor.
• Long-term storage of donor corneal tissue is crucial for addressing donor shortages.

Purpose of the Study:

• To evaluate the long-term efficacy and safety of corneal transplantation using banked donor corneas.
• To assess graft survival rates, visual acuity, and corneal health after 5 years.
• To compare outcomes in pre-operatively defined risk and non-risk groups.

Main Methods:

• Thirty-six corneal transplantations using banked donor corneas stored in organ culture for a mean of 29.5 days at 31°C.
• Follow-up period of 5 years post-transplantation.
• Assessment of graft survival, visual acuity, endothelial cell density, corneal thickness, optical clarity, curvature, astigmatism, intraocular pressure, and corneal sensibility.

Main Results:

• Overall graft survival rate of 80% at 5 years.
• Significantly higher survival in the non-risk group (95.5%) compared to the risk group (49.6%).
• Mean visual acuity of 0.67 cc, with 88% achieving 0.5 cc or better (excluding non-corneal causes).
• Mean central graft thickness of 0.52 mm and endothelial cell density of 862 cells/mm² in surviving grafts.
• All grafts were optically clear, with normal intraocular pressure and some degree of corneal sensibility.

Conclusions:

• Banked donor corneal material maintained in organ culture can be successfully used for corneal transplantation.
• Favorable long-term graft survival and visual outcomes are achievable.
• Pre-operative risk stratification is important for predicting graft success.