Comparison of Fresh Corneal Tissue versus Glycerin-Cryopreserved Corneal Tissue in Deep Anterior Lamellar Keratoplasty

Chen, Wei; Lin, Ying; Zhang, Xiaobo; Wang, Lihua; Liu, Mimi; Liu, Jingbo; Ya, YE; Lee, Sun; Ma, Haijun; Qu, Jia

doi:10.1167/iovs.09-3422

Cited by 57 publications

(43 citation statements)

References 23 publications

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“…The acceptable conditions for PK donors are donor age varying from 1 to 96 years [9][10][11][12][13][14][15][16], endothelial cell density between 2000 and ≥ 3000 cells/mm In contrast to penetrating keratoplasty, donors with quality ranging from fair to excellent are employed for DALK [20,21]. Furthermore, long-term preserved donor tissues completely devoid of cells are also transplanted [22][23][24][25]. One DALK study used donor cornea tissues with age between 12 and 72 years, graft rating from fair to excellent, endothelial cell density (ECD) between 1128 and 4255 cells/mm 2 , death-to-preservation time up to 56 hours, and storage time up to 13 days in Optisol medium (-4°C) [20].…”

Section: Type and Quality Of Donors Used For Pk And Dalkmentioning

confidence: 99%

“…Another DALK study used donors with the following features: age between 28 and 88 years, ECD between 100 and 3300 cells/mm 2 , and storage time up to 35 days in organ culture medium (31°C) [21]. Long-term preserved corneas with mean storage time between 2.7 and 9.6 months are also used for DALK by some surgeons [22][23][24][25]. Frequently, lyophilization or chemical agents are used to dehydrate corneas before cryopreservation [22][23][24].…”

Section: Type and Quality Of Donors Used For Pk And Dalkmentioning

confidence: 99%

“…Long-term preserved corneas with mean storage time between 2.7 and 9.6 months are also used for DALK by some surgeons [22][23][24][25]. Frequently, lyophilization or chemical agents are used to dehydrate corneas before cryopreservation [22][23][24]. However, it is possible to employ cryopreservation without dehydration before freezing as indicated by one study [25].…”

Section: Type and Quality Of Donors Used For Pk And Dalkmentioning

confidence: 99%

“…The results of several studies indicate that cryopreserved corneal tissues can successfully substitute for fresh grafts in DALK using the big-bubble technique. Five studies concluded that long-term cryopreserved donors can provide similar visual results comparable to fresh corneal tissues following DALK [22,23,25,48,49]. Another advantage of long-term preservation of the cornea by lyophilization and chemical glycerin-dehydration is to eliminate cells such as epithelium, keratocytes, and antigen-presenting cells and create the acellular biological materials [22,50].…”

Section: Effect Of Donor and Eye-bank Variables On Clinical Outcomesmentioning

confidence: 99%

“…Five studies concluded that long-term cryopreserved donors can provide similar visual results comparable to fresh corneal tissues following DALK [22,23,25,48,49]. Another advantage of long-term preservation of the cornea by lyophilization and chemical glycerin-dehydration is to eliminate cells such as epithelium, keratocytes, and antigen-presenting cells and create the acellular biological materials [22,50]. As such, acellular corneal tissues may significantly reduce or even eliminate the incidence of graft rejection after lamellar keratoplasty [22,23,25].…”

Section: Effect Of Donor and Eye-bank Variables On Clinical Outcomesmentioning

confidence: 99%

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Donor Graft Quality Used for Penetrating Keratoplasty and Deep Anterior Lamellar Keratoplasty

Feizi¹

2016

Advances in Eye Surgery

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Deep anterior lamellar keratoplasty (DALK) has been recently introduced as an alternative to penetrating keratoplasty (PK) for corneal pathologies not involving corneal endothelium. DALK does not rely on donor endothelium and requires less rigid criteria for donor corneal tissue quality. Therefore, it provides a greater availability of donor corneas that do not need perfectly healthy endothelium and high endothelial cell density to be suitable for PK. Furthermore, as lamellar corneal surgery expands the potential use of acellular corneal tissue, long-term preservation techniques are being revisited as a way to increase availability of corneal tissue to alleviate constraints of availability, cost, storage, and transportation in many countries. The recent alterations in the technique of corneal transplantation and hence the type of donor cornea tissues used for each technique, may require eye banks and corneal surgeons to reassess their selection criteria but it is important for any changes to be evidence-based. The purpose of this chapter, therefore, is to present an updated analysis on the type and quality of donor corneas used for PK and DALK, to evaluate the impact of donor and eye bank variables on the suitability of corneas for transplantation and then go on to determine whether any of these donor factors affect clinical outcomes, complications, and graft survivals.

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Section: Type and Quality Of Donors Used For Pk And Dalkmentioning

confidence: 99%

Section: Type and Quality Of Donors Used For Pk And Dalkmentioning

confidence: 99%

Section: Type and Quality Of Donors Used For Pk And Dalkmentioning

confidence: 99%

Section: Effect Of Donor and Eye-bank Variables On Clinical Outcomesmentioning

confidence: 99%

Section: Effect Of Donor and Eye-bank Variables On Clinical Outcomesmentioning

confidence: 99%

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Donor Graft Quality Used for Penetrating Keratoplasty and Deep Anterior Lamellar Keratoplasty

Feizi¹

2016

Advances in Eye Surgery

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In-body tissue-engineered collagenous connective tissue membranes (BIOSHEETs) for potential corneal stromal substitution

Takiyama

Mizuno

Iwai

et al. 2013

J Tissue Eng Regen Med

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There is a severe shortage of donor cornea for transplantation in many countries. Collagenous connective tissue membranes, named BIOSHEETs, grown in vivo were successfully implanted in rabbit corneal stroma for in vivo evaluation of their suitability as a corneal stromal substitute to solve this global donor shortage. BIOSHEETs were prepared by embedding silicone moulds into dorsal subcutaneous pouches in rabbits for 1 month and stored in glycerol. After re-swelling in saline and trephining, disk-shaped BIOSHEETs (4 mm diameter) were allogeneically implanted into stromal pockets prepared in the right cornea of seven rabbits. Clinical tests for corneal thickness and transparency, and tissue analyses were performed. Because the BIOSHEETs (thickness, 131 ± 14 µm) obtained were opaque immediately after implantation, the transparency of the cornea decreased. The total thickness of the BIOSHEET-implanted cornea increased from 364 ± 21.0 µm to 726 ± 131 µm. After 4 weeks' implantation, the thickness of the cornea stabilized (493 ± 80 µm at 4 weeks and 447 ± 46 µm at 8 weeks). The transparency of the cornea increased progressively with time of implantation. The random orientation of collagen fibrils in the original BIOSHEETs tended to be homogeneous, similar to that of the native stroma. No inflammatory cells accumulated and fibroblast-like cells infiltrated the implant. The BIOSHEETs showed high biocompatibility with stromal tissues; however, further studies are needed to test its functional aspects. Although this research is only intended as a proof of concept, BIOSHEETs may be considered a feasible corneal stromal replacement, especially for treating visual impairment caused by stromal haze. Copyright © 2013 John Wiley & Sons, Ltd.

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Tectonic epikeratoplasty with ethanol-stored donor corneas

et al. 2018

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To evaluate the efficacy and outcomes of tectonic epikeratoplasty with use of ethanol-preserved corneal grafts for the management of perforated corneal melts. The present retrospective case series includes 10 eyes which underwent tectonic epikeratoplasty for perforated corneal melts. The stromal remainders of Descemet membrane endothelial keratoplasty (DMEK) and Descemet stripping automated endothelial keratoplasty (DSAEK) graft preparation were stored in 95% ethanol and used as emergency tectonic grafts for restoring globe integrity after sterile and infectious perforated corneal melts. In 6 cases with subtotal corneal melt, DMEK remainders (endothelium-denuded corneoscleral buttons) were used for 'limbus to limbus' tectonic epikeratoplasty and in 4 cases DSAEK remainders (anterior stroma) were used to seal focal perforated melts. Graft storage time was 5.1 ± 4.9 (ranging from 0.5 to 17) months. The surgeries were successful in all cases with restitution of the globe integrity. During the postoperative course 4 cases developed a graft melt (corneoscleral button for limbus to limbus tectonic epikeratoplasty, n = 3; lamellar patch, n = 1) within 2-6 months after the initial procedure. Three patients underwent successful repeat tectonic epikeratoplasty. In the fourth case of graft melt the globe was enucleated due to underlying expulsive haemorrhage and severe pain. The short-term results of the present case series suggest that the use of ethanol-stored stromal remainder of donor corneas after endothelial keratoplasty is an efficient temporary measure for tectonic restoration of perforated corneas.

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Comparison of Fresh Corneal Tissue versus Glycerin-Cryopreserved Corneal Tissue in Deep Anterior Lamellar Keratoplasty

Abstract: DALK using GCCT provides clinical results comparable to FCT. GCCT can be used safely and effectively for DALK and may minimize stromal rejection after surgery.

Cited by 57 publications

References 23 publications

Donor Graft Quality Used for Penetrating Keratoplasty and Deep Anterior Lamellar Keratoplasty

Donor Graft Quality Used for Penetrating Keratoplasty and Deep Anterior Lamellar Keratoplasty

In-body tissue-engineered collagenous connective tissue membranes (BIOSHEETs) for potential corneal stromal substitution

Tectonic epikeratoplasty with ethanol-stored donor corneas

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