Eye Bank Preparation, Injector Cartridge Preloading, Shipping and Cold Storage of DSAEK Grafts: A Laboratory Study of Endothelial Survival

Abstract

 

Purpose:

 

To evaluate donor endothelial damage occurring in eye bank tissue preloaded in TAN EndoGlide injection cartridges for Descemet’s stripping automated endothelial keratoplasty (DSAEK) compared to standard procedures of donor tissue loaded on-site.

 

Methods:

 

Three corneal buttons were prepared at the Lion's Eye Bank for DSAEK using an automated microkeratome and 8.5mm trephines. The tissue was loaded into intraocular endothelium injector cartridges (TAN EndoGlide, Angiotech, Reading, PA) and shipped overnight. For the control, 3 precut corneas were transported without injector loading. The controls were trephined and immediately loaded into injector cartridges on-site. The endothelium of the grafts was stained with trypan blue 0.4% and alizarin red S 0.5%. Each button was imaged using a Carl Zeiss Stemi SV11 dissecting microscope (0.63x lens, 1.0 zoom). Whole graft images were analyzed and the percentage of endothelial damage was measured.

 

Results:

 

The preloaded corneal buttons demonstrated an average of 20.66% damage to endothelial cells (Figure A, SD=15.1). The control group revealed an average of 11.42% damage (Figure B, SD=3.41). The difference in endothelial damage between the preloaded and control buttons was not statistically significant (p=0.37).

 

Conclusions:

 

Transport of preloaded tissue in TAN EndoGlide injector cartridges resulted in greater endothelial damage than in the control group although results were not statistically significant. A larger sample size is needed to confirm these results. Further studies assessing various eye bank preparations, storage techniques, and devices are ongoing to determine if preloading grafts in injector cartridges prior to transport is a viable option.  

 

 

Keywords: cornea: endothelium • cell survival • clinical laboratory testing