Effects of corneal preservation, donor age, cadaver time and postoperative period on the graft endothelium. A specular microscopic study.

The endothelia of 102 clear human corneal grafts in 95 patients were photographed in vivo with a specular microscope. The endothelial cell densities of the grafts were counted from a area of 0.01 mm2. The follow-up period averaged three years. The patients' ages ranged from 16 to 77 years and that of the donors from 8 to 89 years. The average endothelial cell density for all 102 transplants was 1169 +/- 478 cells/mm2. Corneal transplants stored in MK medium (N = 19) have more cells than cryopreserved grafts (N = 42) or grafts stored in the moist chamber (N = 41); this last group was used as control material. The differences in cell densities were statistically significant. The cell density of cryopreserved grafts was significantly higher than in grafts stored in moist chamber. Only in those grafts in which moist chamber storage had been used was endothelial cell density dependent on time of storage. With an increase in cadaver time (time from death to enucleation), the endothelial cell density of the graft decreased. An inverse correlation was found between the cell density of the graft and donor age. Good results were still found with healthy donors over 60 years. The endothelial cell density of the grafts showed a steady decrease during the long-term post-operative period, the rate of cell loss being much higher in graft endothelium than in normal endothelium during ageing.