Abstract
Purpose :
Porcine eyes are commonly used for training and testing of vitreoretinal surgeries but present limitations due to anatomical differences. While human cadaver eyes work well for exterior work, pupillary visualization is typically too cloudy for vitreoretinal surgery. Our purpose is to describe a method for the preparation of human cadaver eyes that preserves retinal adhesion and allows for clear visualization of the fundus.
Methods :
Human eyes that are not eligible for corneal transplants are procured from a partner eye bank. Tissue is stored in Optisol or Life4C storage media. Vials are shipped on ice and refrigerated once received. The globe is placed in a 3D-printed fixture that replicates eye rotation and fixed in position by clamping the optic nerve. A port is inserted and connected to an infusion line which pressurizes the eye with BSS (balanced salt solution) to ~30mmHg. A corneal trephine blade is used to remove the central cornea. Once removed, 0.12 forceps are used to remove the iris and replicate visualization of a dilated eye. Next, the lens is removed through the corneal opening. Finally, a temporary keratoprothesis (TKP) is sutured onto the sclera. The process is summarized in Figure 1.
Results :
Eyes prepared by this method allow a clear view of the fundus, with sufficient resolution to identify blood vessels and distinguish the microneedles used in subretinal injections. Our team has performed hundreds of subretinal injections using this model. Figure 2 shows representative visualization through the TKP with a subretinal bleb in the top left quadrant.
Conclusions :
Conclusions: A more realistic ex vivo model for vitreoretinal surgery can be achieved with human cadaver eyes by removing the cornea, iris, and crystalline lens, then suturing a TKP to maintain pressure. By shipping eyes in corneal storage media on ice and storing under refrigeration, the retina can remain attached for up to a week post-mortem. This technique can facilitate practice and testing of vitreoretinal surgeries in human eyes.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.