Kartal Eğitim ve Araştırma Hastanesi Kornea Bankası Donörlerine Ait Speküler Mikroskopi Verileri

Abstract

Amaç: Göz bankasında speküler mikroskopinin (SM) gerekliliği açısından donör kornea endotel hücre morfolojisinin donörün epidemiyolojik özellikleri ve ölüm zamanı ile ilişkisini değerlendirmek. Gereç ve Yöntem: Dr. Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi'ne bağlı Kornea Bankası'nda 2010-2012 tarihleri arasında alınan donör kornealara ait speküler mikroskopi (SM) verileri retrospektif olarak değerlendirildi. Bulgular: Yaş ortalaması 40,11±15,51 yıl olan 606 donörden 1180 adet kornea dokusu alınmıştı ve donörlerin 449'u (%74,1) erkek, 157'si (%25,9) kadındı. Kornea alınma süresi, ölüm saati sonrası ortalama 1,52±0,6 saat idi. Endotel hücre sayısı (EHS) ortalama 2852,07±542,15 hücre/mm 2 olup cinsiyete göre anlamlı bir farklılık yoktu (p>0,05). Yaş gruplarına göre ≤20 yaş donörlerde EHS en yüksekti ve diğer yaş grupları ile arada anlamlı farklılık vardı (p<0,001). Ortalama hücre alanı (OHA) 367,86±86,30 µm 2 ; hegzagonalite oranı (%) 49,29±7,76; değişkenlik katsayısı (DK) 31,52±6,37 olup bu değişkenlerle yaş arasında istatistiksel açıdan anlamlı ilişki mevcuttu (p<0,001). Cinsiyete göre OHA anlamlı farklılık gösterirken (p<0,05); cinsiyet ile hegzagonalite ve DK arasında ilişki saptanmadı (p>0,05). Ölüm saati-kornea alınma saati arasında geçen süreye göre gruplar arasında EHS, OHA, DK ve hegzagonalite değerleri için istatistiksel açıdan anlamlı farklılık izlenmedi (p>0,05). Endotel hücre sayısı <2000 hücre/mm 2 olan donörlerin %79'u ≤60 yaş grubunda yer almaktaydı ve >61 yaş grubundaki donörlerin %78'inde EHS ≥2000 hücre/mm 2 idi. Sonuç: Donör kornea morfolojik parametreleri yaş ile anlamlı ilişki göstermesine rağmen EHS<2000 hücre/mm 2 olan donör dağılımı SM'nin keratoplasti öncesi standart bir işlem olarak kullanılması gerektiğini göstermektedir. (Turk J Ophthalmol 2014; 44: 190-5) Anah tar Ke li me ler: Göz bankaları, keratoplasti, doku vericileri, speküler mikroskopi Objective: To evaluate the correlation between donor cornea endothelial cell morphology, epidemiological features of the donor and time of death in terms of necessity of specular microscopy (SM) in eye bank. Materials and Methods: SM data acquired from Dr. Lütfi Kırdar Kartal Training and Research Hospital Cornea Bank between 2010 and 2012 were retrospectively evaluated. Results: One thousand one hundred eighty cornea tissues were excised from 606 donors. The mean age of the donors was 40.11±15.51 years. Four hundred forty-nine (74.1%) donors were male and 157 (25.9%) donors were female. The mean duration of corneal excision was 1.52±0.6 hours after the time of death. The mean endothelial cell density (ECD) was 2852.07±542.15 cells/mm 2 and there was no significant difference with respect to gender (p>0.05). According to age groups, the endothelial cell density was highest at age 20 years and below, and there was a significant difference compared to the other age groups (p<0.001).The mean cell area (MCA) was 367.86±86.30 µm 2 ; the hexagonality rate was 49.29±7.76 (%); the coefficient of variation (CV) was 31.52±6.37 and there was a stat...

Analysis of the cornea donor data: an eye bank study

“…Some studies investigated gender-based differences in endothelial cell morphology, some of them reporting ECC differences between both genders, but some others not [24,25]. Kartal et al [21] reported that female donors had a greater MCA, while a study from India, reported higher CV in female donors [26]. Our results did not reveal any significant difference between both sexes.…”

“…As a general rule, it is recommended that corneal harvesting should be completed within 12 hours [28], although there is still no consensus regarding the upper limit of this time, and it may well be prolonged in some cases [29]. Kartal et al [21] showed that ECC was greatest in the ≤3 hours group, although the difference was statistically non-significant. Our study showed a significant negative correlation between time from death to cornea harvesting and cell count, 6A.…”

“…Besides, the minimum medical standards set by EEBA in 2013, as well as those set by EBAA in 2012, do not specify an age limit for donor eligibility [7,8]. Kartal et al [21] reported that ECC showed a significant negative correlation with age, being significantly greater in the first two decades of life. Likewise, our study revealed a negative correlation between ECC and age.…”

“…Some studies in the literature failed to show any ageassociated differences in CV, MCA, and hexagonality, although some others have reported age-related differences in MCA [22,23]. Kartal et al [21] showed that CV and MCA were significantly lower in Group 1 and 2 (0-40 years of age). In our study, mean endothelial count was 2884.0±457.3, mean SD was 112.7±36.2, mean CV was 31.4±6.7, mean MCA was 354.3±58.4 and mean hexagonality was 61.1±8.6.…”

Postmortem Interval Estimation With Corneal Endothelial Cell Density

“…Parekh et al 25 found that CECD in the central cornea decreased by 0.59% per year, in the paracentral by 0.45% per year, and in the periphery by 0.40% per year (mean, 0.5%–0.6%) because of aging in healthy individuals. In the postmortem period, the highest CECD was detected ≤3 hours 30 . Postmortem interval is not thought to affect endothelial cell viability up to 32 hours postmortem, 31,32 but a longer PMI causes a decrease in endothelial cells 33 …”