Abstract
Purpose :
Endothelial cell (EC) loss is the most frequent cause of corneal transplant failure, thus making endothelial preservation critical for good surgical outcomes. Current corneal storage vials (VC) differ greatly from how the cornea exists naturally, where ECs are isolated and physically separated from the epithelium. Our group developed a novel dual-chamber corneal storage vial (DCV) comprised of two compartments that become isolated by the corneal graft and prevent epithelial and endothelial interaction. We hypothesize that the DCV will improve EC viability and better preserve corneal structure during cold storage.
Methods :
Donor human cornea pairs (N=9) were recovered by the Florida Lions Eye Bank, with one cornea from each pair stored in the VC and the other in the DCV. All cornea pairs were preserved in Optisol-GS media and stored at 2–8°C for 2 weeks. Corneal thickness and EC density were evaluated at days 1, 7, and 14. Osmolarity was measured in preservation media after 2 weeks. Lactate dehydrogenase and annexin V levels were measured in the media and corneal tissue respectively, to assess for cytotoxicity and apoptosis.
Results :
Preliminary results revealed increased corneal thickness in grafts stored in the VC compared to the DCV at days 1, 7, and 14 (p=0.036, p=0.077, and p=0.19, respectively). Osmolarity was significantly increased in both the epithelial (p=0.0015) and endothelial (p=0.0035) compartments of the DCV compared to the VC, suggesting that smaller volumes in DCV compartments may lead to hyperosmolar conditions that preserve corneal stromal hydration. There was no significant difference in EC density between vials. Despite a small sample size, cytotoxicity was lower in the DCV endothelial media than the VC media in 6 of 8 samples (p=0.16), and annexin V concentrations were lower in the DCV endothelium than the VC endothelium in 5 of 6 samples (p=0.10).
Conclusions :
Use of the DCV decreases corneal swelling, increases osmolarity, and potentially reduces endothelial apoptosis during corneal cold storage by physically separating the corneal epithelium and endothelium. The DCV has the potential to transform the way corneal grafts are preserved and will provide scientists with a platform to develop customized preservation solutions.
This is a 2021 ARVO Annual Meeting abstract.