Abstract
Purpose :
To compare tissue suitability for transplantation and eye bank graft preparation outcomes for corneas stored in Eusol-C/Kerasave versus Life4C/Optisol-GS.
Methods :
Eusol-C and Kerasave (without amphoterin-B) are similar solutions and treated as one cohort (Eu/Ker), and Life4C and Optisol-GS was treated as a reference cohort. Corneas recovered for transplantation were examined by technicians within 48 hours of tissue recovery using specular microscopy, slit-lamp, and optical coherence tomography. Endothelial cell density (ECD), corneal thickness, and stromal edema were examined and tissue suitability for PK, DSAEK, and DMEK was determined. For corneas that were subsequently pre-cut for DSAEK or pre-stripped and preloaded for DMEK, graft preparation success rate was compared. Student’s t-tests and Fishers exact tests were used, and statistical significance is defined as P≤0.05.
Results :
While donor age for the Eu/Ker cohort (889 corneas) was higher than the LifeOp cohort (1859 corneas, 67±11 v. 64±13 years, P<0.01), ECD (2525±605 v. 2512±599 cells/mm2, P=0.61) and death-to-preservation time (12.75±4.75 v 12.9±4.75 hours, P=0.33) was not significantly different. Corneas in the Eu/Ker cohort were ~33 µm thicker than those in the LifeOp cohort on the day of processing (P<0.01). Ninety-nine (99%) of all corneas had edema rating of mild or moderate. The Eu/Ker cohort had 191 (21%) corneas rated moderate edema compared to 74 (4%) corneas in the LifeOp cohort (P<0.01). In the Eu/Ker cohort, 72% and 76% of corneas were suitable for PK and DMEK, respectively, which was not different than the 72% and 74% observed in the LifeOp cohort (P=0.96, 0.17). Slightly more corneas were rated suitable for DSAEK in the Eu/Ker cohort than the LifeOp cohort (78% v. 74%, P=0.05). DSAEK and DMEK preparation success rate was 91% and 97%, respectively, in the Eu/Ker cohort compared to 89% and 94% in the LifeOp cohort (P=0.7, 0.09).
Conclusions :
While there are differences in certain characteristics for corneas stored in Eusol-C and Kerasave (w/o amphotericin-B) compared to those stored in Life4C or Optisol-GS, these differences did not affect tissue suitability for PK, DSAEK, and DMEK. Eye bank tissue preparation success rate for DSAEK and DMEK were also not different in this study. Therefore, eye banks and surgeons can feel confident in using Eusol-C and Kerasave corneal storage solutions.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.