June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Effect of organ-culture medium versus cold-culture medium on long-term graft survival after Descemet membrane endothelial keratoplasty
Author Affiliations & Notes
  • Takahiko Hayashi
    Ophthalmology Yokohama City University, Yokohama, KANAGAWA, Japan
    Ophthalmology, University of Cologne, Germany
  • Silvia Schrittenlocher
    Ophthalmology, University of Cologne, Germany
  • Sebastian Siebelmann
    Ophthalmology, University of Cologne, Germany
  • Viet Nhat Hung Le
    Ophthalmology, Hue University, Viet Nam
    Ophthalmology, University of Cologne, Germany
  • Mario Matthaei
    Ophthalmology, University of Cologne, Germany
  • Jeremy Franklin
    Institute of Medical Statistics and Computational Biology, University of Cologne, Germany
  • Björn Bachmann
    Ophthalmology, University of Cologne, Germany
  • Claus Cursiefen
    Ophthalmology, University of Cologne, Germany
  • Footnotes
    Commercial Relationships   Takahiko Hayashi, None; Silvia Schrittenlocher, None; Sebastian Siebelmann, None; Viet Nhat Hung Le, None; Mario Matthaei, None; Jeremy Franklin, None; Björn Bachmann, None; Claus Cursiefen, GENE SIGNAL (C), NOVARTIS (C), ROCHE (C)
  • Footnotes
    Support  Alexander von Humboldt Foundation (https://www.humboldt-foundation.de/web/home.html)
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 3556. doi:
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      Takahiko Hayashi, Silvia Schrittenlocher, Sebastian Siebelmann, Viet Nhat Hung Le, Mario Matthaei, Jeremy Franklin, Björn Bachmann, Claus Cursiefen; Effect of organ-culture medium versus cold-culture medium on long-term graft survival after Descemet membrane endothelial keratoplasty. Invest. Ophthalmol. Vis. Sci. 2020;61(7):3556.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To identify the risk-factors for loss of endothelial cell density (ECD) at one year after Descemet membrane endothelial keratoplasty (DMEK) and to specifically analyze whether donor tissues from cold versus organ culture result in a difference in the long-term corneal graft survival.

Methods : In this retrospective, single center, consecutive study, data of consecutive patients with Fuchs’ endothelial dystrophy who underwent DMEK were selected from the prospective Cologne DMEK Database between 2011 and 2016 at the University of Cologne, Germany, and the risk factors for loss of ECD were determined based on the patient factors (gender, age, lens status, type of surgery, type of tamponade [air or 20% SF6 gas], presence or absence of rebubbling, and immune reactions), early improvement index (BCVA [converted to logMAR], pre-BCVA at 1 month, central corneal thickness (CCT) pre/ CCT 1 month), and donor factors (age, gender, organ- or cold culture, storage time, and baseline ECD).

Results : Totally, 1041 eyes of 841 patients were selected for this study. There was no significant difference in BCVA, CCT and ECD at 12 months between the organ- and cold cultures (p=0.808, 0.931, 0.077; respectively). Immune reactions were more common in cold cultures (p=0.009). Regarding ECD, the ECD in organ culture was 2734 ± 8 (baseline ECD; N=731), 1764 ± 18 (1month, N=345), 1746 ± 21 (3 months, N=286), 1717 ± 20 (6 months, N=354), 1688 ± 20 (12 months, N=417). That of cold culture was 2674 ± 13 (baseline ECD, N=293), 1898 ± 29 (1month, N=134), 1800 ± 33 (3 months, N=119), 1836 ± 33 (6 months, N=135), 1752 ± 31 (12 months, N=171). The ECD was significantly higher in organ culture than in cold culture at 1 month (p=0.002, t-test) and 6 months (p=0.004, t-test) after surgery. Despite the higher ECD loss in organ cultures (38.1± 0.7 %) than in cold cultures (34.3% ± 1.1 %) (p=0.0038), multiple regression analysis proved that only rebubbling was significantly associated with the final ECD loss (p=0.033).

Conclusions : Rebubbling was found to be a key factor for long-term corneal graft survival. Early improvement in vision or transparency was not associated with the final ECD outcome. There was no significant difference between the use of organ- or cold-culture tissue and the final ECD.

This is a 2020 ARVO Annual Meeting abstract.

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