Comparison of Endothelial Cell Density of Organ Cultured Corneas With Cornea Donor Study

Campolmi, N; Hé, Zhiguo; Acquart, Sophie; Trone, Marie Caroline; Bernard, Adeline; Gauthier, Anne‐Sophie; Garraud, Olivier; Forest, Fabien; Péoc’h, Michel; Gain, Philippe; Thuret, Gilles

doi:10.1097/ico.0000000000000124

Cited by 12 publications

(5 citation statements)

References 17 publications

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“…Other studies have claimed that cause of death has minimal to no significant effect on ECD. 1,2,12 It is important to note that head trauma was not analyzed separately in any of these studies; nonetheless, our results are in accordance with these reports that show that cause of death did not have a statistically significant effect on ECD and that donor age is a more relevant and practical factor in predicting ECD in donor corneas. 1,12 The Cornea Donor Study demonstrated that the decrease in endothelial cell density for each year of increase in donor age was most pronounced in donors less than age 60 years.…”

Section: Discussionsupporting

confidence: 91%

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Effect of Head Trauma–Related Deaths on Corneal Endothelial Cell Loss in Eye Bank Donors

Oseni

Rand

Moon

et al. 2022

Cornea

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The purpose of this study was to examine the effect of head trauma-related deaths on corneal endothelial cell density (ECD) in eye bank donors.Methods: This is a retrospective study of 287 corneas from donors with causes of death secondary to motor vehicle accident with sustained head trauma (n = 50), gunshot wound to the head (n = 138), fall with sustained head trauma (n = 2), and nonhead-related traumatic causes of death (n = 97). Donors older than age 50 years were excluded due to concern for undiagnosed Fuchs endothelial dystrophy as a potential confounder for the cause of endothelial cell loss. Donor characteristics, ECD, and focal endothelial cell loss on specular microscopy were compared between the groups. Donors in the head trauma and nonhead trauma groups were matched by age; there were 42 age-matched donors in both groups.Results: Age and ECD were negatively correlated (Pearson correlation coefficient = 20.57). Death-to-preservation time was not significantly different between the 2 groups (P value = 0.59). The mean ECD in the head trauma group was 2859 6 370 cells/mm 2 and 3041 6 464 cells/mm 2 in the nonhead trauma group. The head trauma group had a lower ECD (178 6 70 cells/mm 2 , P value = 0.013). After matching for age, the difference in ECD between the 2 groups was 294 6 82 cells/mm 2 (P value = 0.26). The adjusted odds of having focal endothelial cell loss was not statistically significant (P value = 0.50) between the groups.Conclusions: After statistical adjustments, there were no differences between the head trauma and nonhead trauma groups.

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Section: Discussionsupporting

confidence: 91%

“…E ndothelial cell density (ECD) is an important criteria used to determine the quality of donor cornea tissue. 1,2 Low endothelial cell count is an important reason for the exclusion of donor grafts from being offered and accepted for corneal transplantation. 3,4 Donor age is negatively correlated with ECD.…”

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confidence: 99%

Effect of Head Trauma–Related Deaths on Corneal Endothelial Cell Loss in Eye Bank Donors

Oseni

Rand

Moon

et al. 2022

Cornea

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“…For the two studies, a total of 100 consecutive patients who underwent PK in our department were enrolled during year 2013. We previously determined the variance of the distribution of ebECD in our European donor population (n=1591 consecutive donors) using the same methods of ebECD counting 10. We calculated that a sample of 100 patients would allow obtaining 95% confident intervals with a ±5% width, which we consider as a reasonable accuracy.…”

Section: Methodsmentioning

confidence: 99%

Very early endothelial cell loss after penetrating keratoplasty with organ-cultured corneas

et al. 2016

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Aims After keratoplasty, postoperative endothelial cell loss is calculated between the eye bank endothelial cell density (ebECD) and the postoperative specular microscopy (SM). To elucidate the very early cell loss, always described after penetrating keratoplasty (PK), we designed two complementary studies. Methods (1) Clinical prospective study of 90 consecutive PKs (keratoconus, Fuchs' corneal dystrophy, lattice dystrophy, bullous keratopathy) with organ-cultured corneas and postoperative follow-up by SM at day 5 (D5), D15, month 1 (M1) and M3. This series provided a quantification of the difference between ebECD performed 2 days before graft and very early postoperative ECD. (2) Ten pairs of corneas with comparable ebECD in both corneas and same organ-culture (OC) duration were randomised: one cornea was grafted, and, at the same time, the viable ECD (vECD) of the other was measured after labelling with Hoechst/ethidium/calcein-AM. The relationship between vECD and very early postoperative ECD was studied.Results vECD at the time of graft did not differ from ECD 5 days after PK, with a difference of 39 (−356; 355) cells/mm 2 (median (10°; 90°percentile, p=0.799)), whereas a significant difference of 755 (359; 1146) cells/mm 2 , corresponding to 28% (95% CI 26 to 30) of cells, was measured between ebECD and ECD 5 days after PK ( p<0.001). Conclusions In OC, ebECD provided to surgeons significantly overestimate the number of viable ECs grafted to patients. The absence of difference between the vECD at D0 and ECD at D5 indicates that the very early endothelial cell loss is almost negligible in recipients.

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“…However, measuring ECD in organ culture is limited due to osmotic stress and stromal swelling and consequently endothelial folds due to the presence of dextran and chondroitin sulphate (Campolmi et al. ). Therefore, the three‐dimensional aspect of the stored corneas cannot be taken into account, especially of folds where cell counting results in overestimation caused by parallax error (Gauthier et al.…”

Section: Discussionmentioning

confidence: 99%

Significant differences between specular microscopy and corneal bank endothelial cell counts – a pilot study

Rickmann

Boden

Wahl

et al. 2019

Acta Ophthalmologica

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Background: It was shown recently that endothelial cell count performed by cornea banks overestimates the real number of endothelial cells. The aim of this study was to investigate the internal quality of preclinical ECD in human donor corneas using two widely used methods for endothelial cell counting, transmitted light microscopy used in organ culture tissue bank and clinically used specular microscopy. Methods: Twenty human donor corneas that could not be transplanted were included in this analysis. Differences in evaluating endothelial cell density (ECD) and hexagonal endothelial cell ratio (HEX) between clinical specular microscopy (CSM) and corneal bank transmitted light microscope (CBLM) were evaluated as well as differences between automated and manual cell counts. Results: Automated CBLM showed a higher ECD of 31.85% compared to automated CSM, while manual CBLM counting is 10.51% higher compared to manual CSM (p < 0.01). Further, higher average ECD values result in a higher difference between CSM and CBLM measurements. The manual CBLM ECDs were significantly higher compared to automated derived ECD from CSM (p < 0.01). However, no systematic bias can be detected when comparing the differences of the measurements with the average ECD measurements of both methods.Conclusion: This preclinical pilot study confirmed a significant higher ECD using transmitted light microscopy in organ culture compared to clinical specular microscopy. This indicates that the early rapid decrease of EC universally observed after surgery might be partly artefactual.

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Comparison of Endothelial Cell Density of Organ Cultured Corneas With Cornea Donor Study

Cited by 12 publications

References 17 publications

Effect of Head Trauma–Related Deaths on Corneal Endothelial Cell Loss in Eye Bank Donors

Effect of Head Trauma–Related Deaths on Corneal Endothelial Cell Loss in Eye Bank Donors

Very early endothelial cell loss after penetrating keratoplasty with organ-cultured corneas

Significant differences between specular microscopy and corneal bank endothelial cell counts – a pilot study

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