Role of the Endothelial Layer in the Deswelling Process of Organ-Cultured Human Corneas Before Transplantation.

PURPOSE

Before corneal transplant surgery, a deswelling process of organ-cultured corneas is required. This study compares the deswelling kinetics of corneas with an intact endothelial cell layer and disrupted or removed endothelium by measuring central corneal thickness (CCT) over time using anterior segment spectral domain optical coherence tomography.

METHODS

Ten donor pairs were cultured in organ culture. The right and left corneas were alternately assigned to one of 2 deswelling groups. Deswelling in the first group [endothelial group (EG)] was induced using a medium with dextran 5%. Corneas of the second group [nonendothelial group (NEG)] were deprived of their endothelial cell layer by trypsinization and were then placed in the same deswelling medium. CCT (mean ± SD) was measured by anterior segment spectral domain optical coherence tomography before deswelling (0 hours) and after 1, 2, 3, 6, 12, 24, 48, 72, and 144 hours. Deswelling kinetics was analyzed through the nonlinear platform in SAS/JMP11 Pro.

RESULTS

Before deswelling, CCT was 1071.0 μm (±129.6 μm) and 1133.8 μm (±124.3 μm) in the EG and NEG, respectively. Minimum corneal thickness was obtained after 24 hours in the EG (531.9 ± 47.5 μm) and 6 hours in the NEG (645 ± 81.2 μm). CCT was significantly (P < 0.01) higher in the NEG than EG after more than 6 hours.

CONCLUSIONS

Corneal dehydration after organ culture seems to be a multifactorial process, which not only depends on osmotic effects of the deswelling compound but also requires the presence of an intact endothelial cell layer.