Donor Tissue Culture Conditions and Outcome after Descemet Membrane Endothelial Keratoplasty

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• 作者：Kathrin Laaser ; ^a ; ^{kathrin.laaser@uk-erlangen.de"" rel=""nofollow} ; Bjoern O. Bachmann^a ; Folkert K. Horn^a ; Ursula Schlö ; tzer-Schrehardt^a ; Claus Cursiefen^a ; Friedrich E. Kruse^a [Author vitae]
• 刊名：American Journal of Ophthalmology
• 出版年：2011
• 出版时间：June 2011
• 年：2011
• 卷：151
• 期：6
• 页码：1007-1018.e2
• 全文大小：1641 K

文摘

Purpose

To investigate the effect of culture conditions of donor tissue on functional outcome after Descemet membrane endothelial keratoplasty.

Design

Retrospective, single-center, consecutive case series.

Methods

Descemet membrane endothelial keratoplasty was performed routinely in 82 eyes of 82 consecutive patients using corneal donor tissue prestored in either short-term culture (Optisol-GS; Bausch & Lomb) at 4 C (group A; n = 37) or organ culture (Dulbecco Modified Eagle Medium [Biochrom]; CorneaMax Medium [Eurobio]) at 34 C (group B; n = 45) in a randomized fashion. Main outcome measures included the number of air injections necessary for graft attachment as well as best-corrected visual acuity (in logarithm of the minimal angle of resolution [logMAR] units), central corneal thickness, and endothelial cell density at 1, 3, and 6 months after surgery.

Results

Best-corrected visual acuity increased from 0.69 ± 0.53 logMAR and 0.67 ± 0.31 logMAR before surgery to 0.33 ± 0.21 logMAR and 0.28 ± 0.18 logMAR after 1 month (P < .05), to 0.24 ± 0.16 logMAR and 0.18 ± 0.16 logMAR after 3 months (P < .05), and to 0.18 ± 0.12 logMAR and 0.15 ± 0.10 logMAR after 6 months (n.s.) in groups A and B, respectively. Endothelial cell density decreased from 2647 ± 236 cells/mm² and 2515 ± 249 cells/mm² before surgery to 1499 ± 277 cells/mm² and 1526 ± 205 cells/mm² after 1 month (P < .05), to 1441 ± 213 cells/mm² and 1443 ± 316 cells/mm² after 3 months (n.s.), and to 1587 ± 366 cells/mm² and 1457 ± 285 cells/mm² after 6 months (n.s.) in groups A and B, respectively. Central corneal thickness declined from 664 ± 89 and 662 ± 107 μm before surgery to 529 ± 92 μm and 517 ± 62 μm after 1 month (P < .05), to 511 ± 46 μm and 510 ± 46 μm after 3 months (P < .05), and to 529 ± 68 μm and 507 ± 50 μm after 6 months (n.s.) in groups A and B, respectively. Best-corrected visual acuity, endothelial cell density, and central corneal thickness values showed no significant differences between both groups at any time point after surgery. However, a significantly higher total number of air injections was necessary in group A (n = 34) compared with group B (n = 26) to obtain graft attachment (P < .05).

Conclusions

These findings suggest that donor tissue culture conditions have no significant effect on functional outcome, but may influence graft adhesion and rebubbling rate after Descemet membrane endothelial keratoplasty surgery.