Refractive keratoplasty. Tissue dyes and cryoprotective solutions

The cryoprotective dye solution KM-26 (0.25% kiton green, 8% glycerin, and 4% dimethyl sulfoxide), which is presently used for all lamellar refractive surgical procedures, was evaluated and compared to other dyes that can stain corneal tissue. With the use of canine and human eye bank tissue, we found kiton green and light green to produce the least tissue alteration and to destain readily. Glycerin with or without dimethyl sulfoxide or dye was deleterious to the endothelium in the area under the keratectomized recipient bed. On the basis of our findings, glycerin and dimethyl sulfoxide should be deleted from the cryoprotective solution and a 0.1% concentration of light green in balanced salt solution or M-K medium should be used and the frozen tissue should be thawed in a balanced salt solution or M-K medium to eliminate potential damage to the recipient corneal endothelium.