Near Infra-Red Labelling and Tracking of Transplanted Corneal Endothelial Graft
Abstract Following corneal transplantation, there is an initial decline in corneal endothelial cells (CECs) following graft preparation and surgery. Monitoring post-transplantation is only possible months after surgery by specular microscopy, which has a limited field of view. We have developed a labelling approach using 1,1’-dioctadecyl-3,3,3’,3’-tetramethylindotricarbocyanine iodide (DIR) dye solution, that enabled tracking of labelled CECs in vivo for at least one month. Initial in vitro optimization of dye concentration, cellular toxicity and real-time cell migration was assessed using propagated primary CECs. Subsequent in vivo evaluation of cellular labelling was assessed within a rabbit wound healing model. Finally, real-time visualization of human cadaver donor tissue incubated in DIR transplanted into rabbits was achieved using the Heidelberg Spectralis. Results revealed detectable fluorescence increased with concentration to a plateau of 100µg/ml, with no toxicity of CECs at any concentration evaluated. DIR-labelled CECs were detectable in vivo upto 1 month, and transplanted labelled donor graft could be visualized and were trackable in vivo. Acute endothelial rejection in 1 rabbit was evidenced by detectable DIR positive cells within the anterior chamber. DIR imaging allowed for detailed imaging of the transplanted corneal endothelium, and enabled non-invasive observation of the corneal endothelial morphology following transplantation.