Donor tissue culture conditions and outcome after descemet membrane endothelial keratoplasty.

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/mm(2) and 2515 ± 249 cells/mm(2) before surgery to 1499 ± 277 cells/mm(2) and 1526 ± 205 cells/mm(2) after 1 month (P < .05), to 1441 ± 213 cells/mm(2) and 1443 ± 316 cells/mm(2) after 3 months (n.s.), and to 1587 ± 366 cells/mm(2) and 1457 ± 285 cells/mm(2) 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.