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Fresh and cultured corneal grafts compared by post-operative thickness and endothelial cell density
Insights
Corneal transplantation outcomes are comparable between fresh and cultured grafts, even from older donors with extended post-mortem times. Corneal culture enables the use of aged donor corneas for successful transplantation.
Area of Science:
- Ophthalmology
- Transplantation Medicine
- Tissue Engineering
Background:
- Corneal transplantation is a common procedure to restore vision.
- Graft availability is limited by donor age and post-mortem time.
- Corneal culture techniques may expand donor pool viability.
Purpose of the Study:
- To compare the clinical outcomes of corneal grafts from younger donors (fresh) versus older donors (cultured).
- To evaluate the impact of donor age and post-mortem time on corneal graft success.
- To assess the efficacy of corneal culture in utilizing aged donor corneas for transplantation.
Main Methods:
- Thirty-nine corneas were stored fresh (post-mortem time ≤ 6h, donor age 33 yrs).
- Thirty corneas underwent trypan blue staining and culture (31°C for 24h, post-mortem time 18h, donor age 61 yrs).
- Clinical results, corneal thickness, and endothelial cell loss were assessed one year post-transplantation.
Main Results:
- Fresh grafts were thinner than cultured grafts during the first 10 postoperative days.
- One year post-transplantation, no significant differences were observed in clinical results, corneal thickness, or endothelial cell loss between the two groups.
- Cultured grafts from older donors with extended post-mortem times showed comparable long-term outcomes.
Conclusions:
- Corneal culture is a viable method to expand the donor pool for corneal transplantation.
- Aged donor corneas with extended post-mortem times can be successfully used after individual evaluation and culture.
- Corneal culture does not negatively impact the long-term clinical success of corneal grafts.
Abstract:
Thirty-nine corneas were removed within 6 h post mortem and stored in a moist chamber at 4 degrees C before grafting. The mean donor age was 33 years and the average time between death and grafting was 11 h. Thirty cadaver corneas were selected after trypane blue staining and cultured at 31 degrees C for 24 h before grafting. The mean donor age was 61 years and the mean time between death and culture was 18 h. During the first 10 postoperative days fresh grafts were thinner than cultured grafts. One year after the transplantation the two groups did not differ significantly in regard to the clinical result, corneal thickness, or endothelial cell loss. This indicates that corneas from old donors with extended post mortem time can be used for transplantation after individual evaluation and corneal culture.