The influence of the cause of death and age on human corneal metabolism.

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Abstract

PURPOSE: Little is known about the metabolic status of human corneas before transplantation. The authors attempted to determine the influence of both cause of death and age on the corneal metabolism. METHODS: Adenosine-triphosphate (ATP), adenosine-diphosphate (ADP), glucose, and lactate were measured in the stroma and endothelium of 30 human corneas. The corneas were divided into four groups according to cause of death and four groups according to age. Corneas from donors with diabetes were excluded. RESULTS: Corneas from patients who died suddenly--because of cardiac infarction, for example--have good metabolic status even 24 hours after death. In corneas of patients with cancer or sepsis, the metabolism has run down. In comparison, corneas from patients with cancer are in better metabolic condition than those from donors with sepsis because they have adapted to catabolism. Corneas donated from patients with renal insufficiency show results somewhere in between. Statistical evaluation revealed significant differences in ATP concentrations for corneas from donors who died suddenly and from patients with renal insufficiency compared to corneas from patients with sepsis. It could be shown that glucose concentrations as a resource for metabolism increase with age. The best ATP-ADP ratios were found in the group of 40- to 59-year-old donors. Nevertheless, differences between the age groups were not statistically significant. CONCLUSION: From our results it can be concluded that the cause of death and systemic metabolism have an influence on corneal metabolism. Results concerning donor age reflect the well-known fact that donor age has no influence on the quality of keratoplasty material.