Comparative Performance Analysis of Corneal Characteristics During Extended Hypothermic Storage in XTRA4 and...

Area of Science:

• Ophthalmology
• Corneal Preservation
• Tissue Engineering

Background:

• Extended hypothermic storage of donor corneas is crucial for transplantation logistics.
• Current storage solutions have limitations in maintaining corneal integrity over extended periods.
• Optimizing storage media is essential for improving graft survival and expanding donor pool accessibility.

Purpose of the Study:

• To compare the efficacy of XTRA4 and Optisol-GS in preserving donor cornea morphometry, thickness, and transparency during extended hypothermic storage.
• To evaluate endothelial cell morphometry (density, CV, HEX) and viability.
• To assess corneal thickness (CCT) and stromal edema, as well as Descemet folds.

Main Methods:

• Donor corneas were stored in XTRA4 or Optisol-GS at 2-8°C for up to 28 days.
• Specular microscopy assessed endothelial cell density, coefficient of variation (CV), and hexagonality (HEX).
• Optical Coherence Tomography (OCT) measured central corneal thickness (CCT), and slit lamp examination graded endothelium quality, stromal edema, and Descemet folds.

Main Results:

• Endothelial cell density, CV, and HEX were comparable between XTRA4 and Optisol-GS through 21 days; HEX was higher in XTRA4 on day 28.
• Corneal thickness was similar through day 7, but XTRA4 corneas were significantly thinner beyond day 7.
• XTRA4 demonstrated a significantly smaller increase in stromal thickness and reduced stromal edema compared to Optisol-GS over extended storage.

Conclusions:

• XTRA4 preserves corneal endothelium similarly to Optisol-GS for up to 14 days.
• XTRA4 exhibits superior antiswelling properties, maintaining thinner corneas for up to 28 days.
• The antiswelling characteristic of XTRA4 may enhance eye bank logistics and support research for extending corneal storage limits.