Endothelial viability of organ-cultured corneas following penetrating keratoplasty

Purpose To assess endothelial integrity following corneal transplantation using human corneas stored in organ culture in the Manchester Eye Bank. Methods A prospective study was undertaken on 24 patients who had received full-thickness corneal grafts using corneas stored in organ culture. The donor corneal endothelium was photographed prior to transplantation using light microscopy. Specular microscopy and ultrasonic pachometry were performed at 30 days (+/- 3 days), 12 weeks (+/- 1 week), 26 weeks (+/- 2 weeks) and 52 weeks (+/- 4 weeks) following corneal transplantation. The following cell parameters were measured: density, area, coefficient of variation (CV) for area, perimeter, diameter, form factor and corneal thickness. Results One year after corneal transplantation there was a statistically significant decrease in endothelial cell density (-39.4%), and a statistically significant increase in endothelial cell area (+94.4%), perimeter (+36.1%), diameter (+57.1%) and form factor (+5.8%). However, no significant changes were seen in CV or corneal thickness with respect to time after transplantation. (There were no significant changes in endothelial fell parameters and corneal thickness for 12 control subjects,) Conclusions Endothelial cell loss occurs at an accelerated rate from corneal transplants. This highlights the need for improving corneal endothelial viability during and after storage in order to improve the chances of longer-term survival of the transplanted cornea.