Borderie V, Laroche L, Vedie F, Lopez M
Service d'Ophtalmologie, Hôpital Saint-Antoine, Paris.
J Fr Ophtalmol. 1995;18(10):570-7.
To evaluate the clinical results of corneal transplantations using organ-cultured donor corneas.
We retrospectively studied our 50 first penetrating keratoplasties performed with corneas organ-cultured for 2 to 5 weeks at +31 degrees C (Inosol medium, Opsia). The average follow-up is 11.6 months. The main indications for grafting were bullous keratopathy (56%) and keratoconus (26%).
At 1 year, the graft survival rate was 81%. The causes of graft failure were immune rejection (n = 3), non immune secondary endothelial decompensation (n = 3) and uncontrolled glaucoma (n = 1). The average endothelial density during the second year was 1,349 cell/mm2. It was 1,852 in the group of keratoconus and 751 in the group of bullous keratopathy. The average corrected visual acuity was 20/66 at 12 months. It was 20/45 in the group of keratoconus and 20/125 in the group of bullous keratopathy. The average astigmatism was 4.9 D, but running suture was still present at 12 months in most patients. Compared with graft survival after storage at +4 degrees C (retrospective paired control group), graft survival was higher after organ culture, but the difference does not reach the statistical significant threshold (p = 0.07).
Organ culture is able to ensure the quality of corneal endothelium and then avoids non immune primary graft failure.
