Analysis of factors affecting the decrease of endothelial cell density of imported donor corneas

To evaluate the impact of death-to-preservation time (DPT) on effective utilisation of donor corneas. In a prospective observational study conducted at our tertiary eye centre, donated corneas received over a 15-month period from November 2011 to January 2013 were evaluated. Donor age, donor refrigeration (done or not), DPT, endothelial cell density (ECD), corneal grading, clinical utilisation and surgical outcome after graft transplantation were noted. To analyse the impact of different DPT on donor cornea transplantation, primary outcome measures (corneal grading and endothelial cell density) and secondary outcome measures (primary graft failure and graft infection) were analysed. A total of 990 corneas were assessed. Primary outcomes showed no significant difference for higher DPT ( P > 0.01). ECD, where DPT was >12 h, was better for refrigerated corneas ( P < 0.001). Prolonged DPT had no significant effect on primary graft failure ( P = 0.131) and graft infection ( P = 0.137) in the first month after transplantation. We find that DPT should not be the only criteria to assess the cornea quality; other donor characteristics should be considered equally important. Donor refrigeration should be encouraged in cases where early retrieval is not possible.

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Utilization rate and usage patterns of phakic and pseudophakic donor corneas recovered by the Singapore Eye Bank

PLoS ONE ◽

10.1371/journal.pone.0260523 ◽

2021 ◽

Vol 16 (12) ◽

pp. e0260523

Author(s):

Sai Kyauk ◽

Howard Y. Cajucom-Uy ◽

Hla Myint Htoon ◽

Z. Zaw Htoi Aung ◽

Jodhbir S. Mehta ◽

...

Keyword(s):

Endothelial Cell ◽

Cataract Surgery ◽

Cell Density ◽

Endothelial Cell Density ◽

Utilization Rate ◽

Eye Bank ◽

Descemet's Membrane ◽

Usage Patterns ◽

Descemet’S Membrane ◽

Donor Corneas

Purpose To compare the utilization rate and usage patterns of pseudophakic and phakic donor corneas recovered by the Singapore Eye Bank. Methods Records of local donor corneas recovered by the Singapore Eye Bank from 2012 to 2017 were examined. Corneas that were deemed suitable for clinical use were stratified into phakic and pseudophakic groups. We examined the basic demographic pattern of both groups and the initial type of surgery/ies that the corneas were suitable for based on tissue parameters such as time from harvesting, stromal clarity, the clear central corneal area, the presence of Descemet’s membrane tears or defects, and endothelial cell density and quality. We also identified the types of corneal grafts that the corneas were eventually used for; Penetrating Keratoplasty (PK), Anterior Lamellar Keratoplasty (ALK), Endothelial Keratoplasty (EK). Finally, the overall utilization rates for each group were determined. Results A total of 986 corneas deemed suitable for transplant were analyzed, 908 (92%) were phakic and 78 were pseudophakic (8%). The average age of pseudophakic donor corneas was (65 ± 8 yrs. old) and there was a slight male preponderance for both groups (55%). Age adjusted analysis of pseudophakic corneas showed the endothelial cell density (ECD) (mean: 2327 ± 47.1 cells/mm2) and clear area (mean: 7.0 ± 0.7 mm) were lesser than phakic corneas. The percentage of pseudophakic corneas that were of EK standard (ECD >2500 cells/mm2) were lower compared to phakic corneas (37% and 77% respectively, p < 0.001). There was significant correlation between previous cataract surgery and the endothelial cell count of the donor corneas (p < 0.001), and regression analysis also showed a strong association of ECD with cataract surgery in reference to non-cataract surgery (-478.8 (95% CI-576.9 to -380.7). The overall utilization rate for pseudophakic corneas was 58% compared to that of phakic corneas at 83%. The most common reason for pseudophakic corneas not to be utilized was due to the presence of Descemet’s membrane (DM) tears or defects under the main or side port incision created during phacoemulsification (30%). Phakic corneas were used primarily for optical grafts 84% (mainly EK) while pseudophakic corneas were used mostly for therapeutic/tectonic grafts 47% (mainly ALK or patch grafts). Conclusion Compared to phakic donor corneas, pseudophakic corneas generally have lower overall tissue quality leading to lower uptake by surgeons and lower utilization rates. Eye banks must continuously refine their donor acceptance criteria and engage surgeons to optimize utilization of each recovered tissue.

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Evaluation of repeatability for the automatic estimation of endothelial cell density in donor corneas

British Journal of Ophthalmology ◽

10.1136/bjo.2006.112763 ◽

2007 ◽

Vol 91 (9) ◽

pp. 1213-1215 ◽

Cited By ~ 5

Author(s):

A. Ruggeri ◽

E. Grisan ◽

J. Schroeter

Keyword(s):

Endothelial Cell ◽

Cell Density ◽

Endothelial Cell Density ◽

Automatic Estimation ◽

Donor Corneas

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Analyses of Factors Affecting Endothelial Cell Density in an Eye Bank Corneal Donor Database

Cornea ◽

10.1097/ico.0000000000000921 ◽

2016 ◽

Vol 35 (9) ◽

pp. 1206-1210 ◽

Cited By ~ 12

Author(s):

Ji Won Kwon ◽

Kyong Jin Cho ◽

Hong Kyu Kim ◽

Jimmy K. Lee ◽

Patrick K. Gore ◽

...

Keyword(s):

Endothelial Cell ◽

Cell Density ◽

Endothelial Cell Density ◽

Eye Bank ◽

Factors Affecting ◽

Corneal Donor

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The Effect of Diabetes Mellitus on Corneal Endothelial Cells and Central Corneal Thickness: A Case-Control Study

Ophthalmic Research ◽

10.1159/000507197 ◽

2020 ◽

Vol 63 (6) ◽

pp. 550-554

Author(s):

Panagiota Papadakou ◽

Irini Chatziralli ◽

Miltiadis Papathanassiou ◽

Vaia Lambadiari ◽

Charalambos S. Siganos ◽

...

Keyword(s):

Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Endothelial Cell ◽

Cell Density ◽

Corneal Endothelium ◽

Central Corneal Thickness ◽

Corneal Thickness ◽

Endothelial Cell Density ◽

Corneal Endothelial Cells ◽

Factors Affecting

Purpose: The aim of this study was to evaluate the characteristics of corneal endothelial cells and central corneal thickness (CCT) in patients with diabetes mellitus (DM), comparing them with those of healthy subjects (controls) and to determine potential factors affecting the corneal parameters in patients with DM. Methods: Participants in this study were 72 patients with DM and 88 healthy controls. Diabetic patients were further classified into groups depending on the severity of diabetic retinopathy (no retinopathy, mild, moderate, severe non-proliferative diabetic retinopathy, and proliferative diabetic retinopathy). All participants underwent non-contact specular microscopy to evaluate corneal endothelium parameters and CCT, while factors affecting endothelial cell density and CCT in patients with DM were also analyzed. Results: Patients with DM presented significantly decreased endothelial cell density compared to controls (2,297.9 ± 311.3 and 2,518.3 ± 243.7 cells/mm2, respectively; p < 0.001), while the two groups did not differ significantly in any other measured corneal parameter. In the diabetic group, the multivariate analysis showed a significant association between decreased endothelial cell density and increased HbA1c (p < 0.001), longer DM duration (p = 0.003), and more severe diabetic retinopathy status (p = 0.008). Conclusion: DM seems to affect the corneal endothelium, since endothelial cell density was decreased in the diabetic group, while duration of disease, HbA1c levels, and severity of retinopathy were significantly associated with changes in endothelial cell density and should be taken into account.

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