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E Zanetti, D Camposampiero, D Ponzin, S Giuffrida, C Bucolo, M Cro, P Rama; Hyaluronate as a Deturgescent Agent During the Transport Phase of Corneal Storage by Organ Culture . Invest. Ophthalmol. Vis. Sci. 2002;43(13):134.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: Corneal swelling, which occurs during storage by organ culture, must be reversed before transplantation by a deturgescent agent, such as dextran, during the transport phase. Hyaluronic acid (HA) is a glycosaminoglycan that plays structural and functional roles in ocular and non-ocular tissues. We investigated the potential of a modified, HA-based E-MEM, as a transport medium in organ culture. Methods: Ten corneas, from 9 donors, unsuitable for penetrating keratoplasty, were stored at 31°C using the conventional E-MEM modified medium. After a mean storage of 17 days (min 15, max 20), the corneas were evaluated by light microscopy; corneal thickness, endothelial density and mortality were measured; epithelium and corneal transparency were subjectively assessed. The corneas were then transferred into modified E-MEM containing 2% HA, m.w. 100 KDa (IALUSOL, Fidia Oftal – Baush & Lomb), and re-evaluated after a mean of 5 days (min 4, max 6). Results: Eight corneas presented an improvement in transparency, while 2 corneas maintained a poor stromal appearance. All tissues showed a reduction in thickness from 795 ± 94 to 575 ± 54 mm (mean ± SD). The endothelial density remained unchanged, or showed a slight decrease, in 7 corneas, which had not presented severe degeneration before storage; these corneas also exhibited a corresponding reduction in the number of trypan blue positive cells, that were largely replaced by neighbouring cells. Five corneas showed a marked decrease in epithelial adhesion. Conclusion: HA can act as a deturgescent agent during the transport phase of organ culture and allows repair of the corneal endothelium. In order to assess the potential of HA as a medium supplement, these results must be confirmed with corneas free of degeneration. The effect on the viability and adherence of the corneal epithelium must be further elucidated.
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