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Wang Q, Liu Y, Gao Y, Zhang M, Yang L, Hu J, Ren Y, Zhou Q, Zhu M. Comparison of the structural integrity and quality of corneal endothelium stored in organ culture storage medium versus Eusol-C. Cell Tissue Bank 2024:10.1007/s10561-024-10138-z. [PMID: 38822224 DOI: 10.1007/s10561-024-10138-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 04/29/2024] [Indexed: 06/02/2024]
Abstract
In this experimental study, we compared the structural integrity and cell quality of corneal endothelium stored in organ culture medium (OCS) and Eusol-C. The experiment included rabbit and human cornea experiments in vitro. Thirty rabbit corneas and thirty-two human corneas were collected and divided into two groups. All right corneas were allocated in experiment group and left corneas were placed in control group. The corneas in experimental group were stored in OCS at 34 °C, and the corneas in control group were stored in Eusol-C at 4 °C for 7, 14, 21, 28, and 35 days, respectively. Endothelial cell morphology, cell count, and trypan blue staining for viability were assessed before storage (Day 0) and at days 7, 14, 21, 28 and 35. The structural integrity of human corneal endothelial cell was analyzed using immunohistochemistry. The samples of storage solution for microbial culture were collected on the third day and at the end of storage. The results show that no bacterial and fungal infections were found in both groups. After 14 days of storage, the morphology of endothelial cell was better in the experimental group than in the control group. The endothelial cell stored in OCS were better than those stored in Eusol-C at the end of storage times, except human cornea 14 days storage group. The ZO-1 protein staining showed the typical polygonal morphology of endothelial cell stored in the OCS. Corneal endothelial cells stored in the OCS had better quality up to 28 days. It can be applied to Chinese eye banks as a method of corneal preservation.
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Affiliation(s)
- Qin Wang
- Chongqing Eye and Vision Care Hospital, Aier Eye Hospital Group, No. 77, Daping Changjiang Second Road, Yuzhong, Chongqing, 400040, China
| | - Yonghuan Liu
- Changsha Aier Eye Hospital, Aier Eye Hospital Group, Changsha, 410015, China
| | - Yang Gao
- Chongqing Eye and Vision Care Hospital, Aier Eye Hospital Group, No. 77, Daping Changjiang Second Road, Yuzhong, Chongqing, 400040, China
| | - Ming Zhang
- Chongqing Kaizhou Aier Sunshine Eye Hospital, Aier Eye Hospital Group, Kaizhou, 404000, China
| | - Lihong Yang
- Changsha Aier Eye Hospital, Aier Eye Hospital Group, Changsha, 410015, China
| | - Jian Hu
- Drug Delivery Laboratory, Aier Eye Hospital Group, Changsha, 410015, China
| | - Yi Ren
- Chongqing Aier Eye Hospital, Aier Eye Hospital Group, Chongqing, 400020, China
| | - Qizhi Zhou
- Chongqing Eye and Vision Care Hospital, Aier Eye Hospital Group, No. 77, Daping Changjiang Second Road, Yuzhong, Chongqing, 400040, China.
| | - Meidong Zhu
- The New South Wales Tissue Bank, New South Wales Organ and Tissue Donation Service, North Block, Sydney and Sydney Eye Hospital, 8 Macquarie Street, Sydney, Australia.
- Aier Eye Research Institute,Aier Eye Hospital Group, Beijing, China.
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2
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Alemi H, Wang S, Blanco T, Kahale F, Singh RB, Ortiz G, Musayeva A, Yuksel E, Pang K, Deshpande N, Dohlman TH, Jurkunas UV, Yin J, Dana R. The Neuropeptide α-Melanocyte-Stimulating Hormone Prevents Persistent Corneal Edema following Injury. THE AMERICAN JOURNAL OF PATHOLOGY 2024; 194:150-164. [PMID: 37827217 PMCID: PMC10768537 DOI: 10.1016/j.ajpath.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 09/03/2023] [Accepted: 09/12/2023] [Indexed: 10/14/2023]
Abstract
Corneal endothelial cells (CEnCs) regulate corneal hydration and maintain tissue transparency through their barrier and pump function. However, these cells exhibit limited regenerative capacity following injury. Currently, corneal transplantation is the only established therapy for restoring endothelial function, and there are no pharmacologic interventions available for restoring endothelial function. This study investigated the efficacy of the neuropeptide α-melanocyte-stimulating hormone (α-MSH) in promoting endothelial regeneration during the critical window between ocular injury and the onset of endothelial decompensation using an established murine model of injury using transcorneal freezing. Local administration of α-MSH following injury prevented corneal edema and opacity, reduced leukocyte infiltration, and limited CEnC apoptosis while promoting their proliferation. These results suggest that α-MSH has a proregenerative and cytoprotective function on CEnCs and shows promise as a therapy for the prevention and management of corneal endothelial dysfunction.
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Affiliation(s)
- Hamid Alemi
- Laboratory of Corneal Immunology, Transplantation and Regeneration, Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Shudan Wang
- Laboratory of Corneal Immunology, Transplantation and Regeneration, Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Tomas Blanco
- Laboratory of Corneal Immunology, Transplantation and Regeneration, Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Francesca Kahale
- Laboratory of Corneal Immunology, Transplantation and Regeneration, Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Rohan B Singh
- Laboratory of Corneal Immunology, Transplantation and Regeneration, Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Gustavo Ortiz
- Laboratory of Corneal Immunology, Transplantation and Regeneration, Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Aytan Musayeva
- Laboratory of Corneal Immunology, Transplantation and Regeneration, Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Erdem Yuksel
- Laboratory of Corneal Immunology, Transplantation and Regeneration, Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Kunpeng Pang
- Laboratory of Corneal Immunology, Transplantation and Regeneration, Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Neha Deshpande
- Laboratory of Corneal Immunology, Transplantation and Regeneration, Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Thomas H Dohlman
- Laboratory of Corneal Immunology, Transplantation and Regeneration, Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Ula V Jurkunas
- Laboratory of Corneal Immunology, Transplantation and Regeneration, Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Jia Yin
- Laboratory of Corneal Immunology, Transplantation and Regeneration, Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Reza Dana
- Laboratory of Corneal Immunology, Transplantation and Regeneration, Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.
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Zhang H, Deng Y, Li Z, Tang J. Update of Research Progress on Small Incision Lenticule Extraction (SMILE) Lenticule Reuse. Clin Ophthalmol 2023; 17:1423-1431. [PMID: 37251989 PMCID: PMC10216859 DOI: 10.2147/opth.s409014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 05/12/2023] [Indexed: 05/31/2023] Open
Abstract
The SMILE lenticule is a complete corneal stroma that is removed from SMILE surgery. Since the increasing number of SMILE surgeries, a large number of SMILE lenticules have been produced, so the reuse and preservation of the stromal lens has become a research hotspot. Due to the rapid development of the preservation and clinical reuse of SMILE lenticules, there have been many related studies in recent years, so we updated it on this basis. We searched PubMed, Web of Science, Embase, Elsevier Science, CNKI, WANFANG Data and other databases for all articles published on the preservation and clinical reuse of SMILE lenticules, screened useful articles, selected relevant articles published in the last five years as the main body for summary, and then reached a conclusion. The existing preservation methods of SMILE lenticule include Moist chamber storage at low temperature, cryopreservation technique dehydrating agent and corneal storage medium, which have their own advantages and disadvantages. Presently, smile lenticules can be used for the treatment of corneal ulcers and perforations, corneal tissue defects, hyperopia, presbyopia and keratectasia, which have been proven to be relatively effective and safe. More research on smile lenticule reuse needs to be carried out to confirm its long-term efficacy.
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Affiliation(s)
- Hao Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Yingping Deng
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Zeshi Li
- West China Clinical Medical College, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Jing Tang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
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Kaluzny BJ, Mlyniuk P, Liberski S, Jimenez-Villar A, Machalińska A, Grulkowski I. Swept-source OCT for corneal graft quantitative evaluation in the eye bank and the correlation of the measurements to pre-excision values. Sci Rep 2022; 12:14834. [PMID: 36050445 PMCID: PMC9437096 DOI: 10.1038/s41598-022-19225-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/25/2022] [Indexed: 11/15/2022] Open
Abstract
Quantitative evaluation of the human corneal grafts stored in the tissue banks is usually limited to endothelial cell density and central thickness. Swept-source OCT (SS-OCT) is capable of measuring the central curvatures of the corneal tissue prepared for transplantation without loss of sterileness, providing insights on its refractive state. The aim of the paper is to compare in vitro SS-OCT measurements with pre-excision values. Hand-held keratometry and ultrasound pachymetry was performed on 22 corneas before excision of corneoscleral button and insertion in the vial with Eusol-C solution (AlchimiaS.r.l, Nicolò, Italy). After 12 to 36 h of hypothermic storage the corneas were examined within the vials with custom built SS-OCT system maintaining a sterile environment. The anterior and posterior central curvatures, and central corneal thickness (CCT) were measured. Rotation of the corneoscleral button was controlled by making a 6-o'clock mark during excision. Mean pre-excision CCT was 626.45 ± 28.71 µm and 468.05 ± 52.96 µm when measured with SS OCT (r = 0.55; p < 0.001). Respective values for average keratometry were 7.74 ± 0.39 mm and 7.92 ± 0.57 mm (r = 0.6; p = 0.22). Although high differences were observed in corneal thickness, keratometric radius of curvature at the flat (r = 0.42; p < 0.001) and steep (r = 0.62; p = 0.014) meridian of the anterior corneal surface, as well as corneal anterior astigmatism (r = 0.3; p < 0.001), showed good correlation with pre-excision values. SS-OCT is capable of providing quantitative evaluation of the human corneal grafts in hypothermic storage. Good correlation between curvature measurements before excision and during banking in the vial indicates its clinical utility.
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Affiliation(s)
- Bartlomiej J Kaluzny
- Division of Ophthalmology and Optometry, Department of Ophthalmology, Collegium Medicum, Nicolaus Copernicus University, Ul. K. Ujejskiego 75, 85-168, Bydgoszcz, Poland.,Oftalmika Eye Hospital, Bydgoszcz, Poland
| | - Patryk Mlyniuk
- Division of Ophthalmology and Optometry, Department of Ophthalmology, Collegium Medicum, Nicolaus Copernicus University, Ul. K. Ujejskiego 75, 85-168, Bydgoszcz, Poland.,Oftalmika Eye Hospital, Bydgoszcz, Poland
| | - Slawomir Liberski
- Department of Ophthalmology, Poznan University of Medical Sciences, Ul. A. Szamarzewskiego 84, 61-848, Poznań, Poland.
| | - Alfonso Jimenez-Villar
- Institute of Physics, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University, Ul. Grudziądzka 5, 87-100, Toruń, Poland
| | - Anna Machalińska
- First Department of Ophthalmology, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111, Szczecin, Poland
| | - Ireneusz Grulkowski
- Institute of Physics, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University, Ul. Grudziądzka 5, 87-100, Toruń, Poland
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Cold Storage Media versus Optisol-GS in the Preservation of Corneal Quality for Keratoplasty: A Systematic Review. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12147079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Optisol-GS is the most widely used pharmaceutical composition to preserve corneas for transplantation. This systematic review investigated the effects of different cold corneal storage media (CCSM) compared with Optisol-GS on the quality of stored corneas. The literature was searched throughout May 2022 on six databases and grey literature. Studies including corneas (population) exposed to distinct cold storage media (exposure) and Optisol-GS (comparison) that reported qualitative and/or quantitative parameters of cornea quality (outcome) were included. Methodological quality was assessed using ToxRTool. From 4520 identified studies, fourteen were included according to the eligibility criteria, comprising 769 evaluated cornea samples comparing Optisol-GS with commercial and noncommercial media. All studies showed good methodological quality. Experimental times ranged from 1–28 days, mainly using 4 °C as the preservation temperature. Viable endothelial cell density (ECD) and endothelial cell morphology (EC) were the most assessed parameters. ECD results for Cornisol were higher than Optisol-GS in 10 days (p = 0.049) and favored Cornea ColdTM up to 4 weeks (p < 0.05), which also showed better qualitative results. While the standardization of test protocols could improve comparisons, evidence indicates that most CCSM present similar performances on cornea preservation for transplantation at seven days, while some formulations may increase preservation at extended times.
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Overview of Short-Term and Intermediate-Term Corneal Storage Solution: Comparison of Clinical Outcomes and Need For Future Research. Eye Contact Lens 2022; 48:141-148. [PMID: 35296625 DOI: 10.1097/icl.0000000000000875] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2021] [Indexed: 11/26/2022]
Abstract
ABSTRACT Corneal donor tissue preservation techniques have incrementally improved since the introduction of McCarey-Kaufman storage solution from short-term storage to intermediate duration of storage with the advent of organ culture and Optisol GS storage solutions. Improved understanding of the corneal endothelial cell physiology has helped in designing newer storage solutions, such as the Life 4C and Cornea Cold. The incorporation of antibiotics, ATP precursors, minerals, and vitamins has improved the viability of tissues. In addition, these modifications to the newer storage solutions have increased the endothelial longevity and metabolic activity. Despite these advances, the duration of tissue storage has largely been restricted to 2 weeks in Optisol GS and 4 weeks in organ culture. The role and cost-effectiveness of antifungal supplementation and the need for improved epithelial preservation are additional areas that need to be explored. This review intends to summarize the efficacy and viability of donor corneas in different tissue storage solution and compare clinical outcomes while providing an insight into the challenges in developing newer methods of corneal preservation.
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7
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Sinasol versus Optisol-GS for cold preservation of human cornea: a prospective ex vivo and clinical study. Cell Tissue Bank 2021; 22:563-574. [PMID: 33937957 DOI: 10.1007/s10561-021-09930-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 04/20/2021] [Indexed: 10/21/2022]
Abstract
To compare ex vivo results of donor corneas maintained in Sinasol with those stored in Optisol-GS and reporting clinical outcomes of grafted Sinasol-versus Optisol-GS-stored corneas. In phase I, paired donor corneas were maintained in Sinasol or Optisol-GS. Afterward, the corneas were subjected to slit-lamp biomicroscopic and specular microscopic examinations on days 1 and 7, and then to trypan blue staining on day 7. The same examinations were performed on the corneas that were kept in Sinasol or Optisol-GS for 14 days. In phase II, the post-operative reports of 72 consecutive corneal transplantations were recorded using Sinasol- or Optisol-GS-preserved corneas. In phase I, 128 corneas from 64 donors and 59 corneas from 33 donors were investigated for 7 and 14 days, respectively. The EC indices were comparable between the groups at the measurement periods. The EC losses over 7 and 14 days were 3.7% and 19.9% in Sinasol against 4.6% and 20.8% in Optisol-GS. Although fair quality corneas were more common in Optisol-GS group after 7 (P = 0.04) and 14 days (P = 0.034), changes of stromal edema, Descemet's fold, and other quality ratings during 14 days were not different between the groups. In phase II, all the transplanted corneas were postoperatively clear with no adverse reactions. The overall results indicate that Sinasol is a safe, effective, and affordable intermediate cold storage medium for preservation of corneas.
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Mistò R, Giurgola L, Pateri F, Limongelli A, Ragazzi E, D'Amato Tóthová J. A new storage medium containing amphotericin B versus Optisol-GS for preservation of human donor corneas. Br J Ophthalmol 2020; 106:184-189. [PMID: 33172862 DOI: 10.1136/bjophthalmol-2020-317136] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/21/2020] [Accepted: 10/17/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND/AIM We compared the quality of human donor corneas stored in a cold storage medium containing 2.5 μg/ml of amphotericin B (Kerasave, AL.CHI.MI.A. S.R.L., Ponte San Nicolò, Italy) and Optisol-GS (Bausch & Lomb Inc., Bridgewater, NJ, USA) for 14 days. METHODS Sixteen pairs of human donor corneas were collected in Eusol-C (AL.CHI.MI.A. S.R.L., Ponte San Nicolò, Italy). Next, all tissues underwent the first evaluation that included the assessments of central corneal thickness (CCT), endothelial cell density (ECD) measured using both trypan blue staining and specular microscopy, endothelial cell (EC) mortality and morphology, and corneal transparency within 24 hours from recovery (Day 1). Afterwards, one cornea of each pair was transferred into Kerasave or Optisol-GS. ECD and CCT were also assessed at Day 7, and all the metrics were evaluated again at the end of the storage period (Day 14). RESULTS At all tested time points, no differences were found in the qualitative (corneal transparency, EC morphology) and quantitative metrics (ECD, CCT, EC mortality) between the Kerasave and the Optisol-GS storage groups. At Day 14, the corneas stored in Kerasave and Optisol-GS showed ECD of 2312±98 and 2335±128 cells/mm2 (p=0.886), CCT of 717±17 and 697±19 μm (p=0.454) and central EC mortality of 0.54%±0.40% and 0.14%±0.14% (p=0.719), respectively. CONCLUSIONS The new amphotericin B-containing medium Kerasave was comparable to Optisol-GS in terms of preservation of corneal characteristics at 2-8°C for 14 days.
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Affiliation(s)
- Raffaela Mistò
- Eye Bank of Monza, Azienda Ospedaliera San Gerardo, Monza, Italy
| | | | - Francesca Pateri
- Eye Bank of Monza, Azienda Ospedaliera San Gerardo, Monza, Italy
| | - Anna Limongelli
- Eye Bank of Monza, Azienda Ospedaliera San Gerardo, Monza, Italy
| | - Eugenio Ragazzi
- Department of Pharmaceutical and Pharmacological Sciences, Università Degli Studi Di Padova, Padova, Italy
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A new storage solution for the hypothermic preservation of corneal grafts: an experimental study. Cell Tissue Bank 2020; 21:507-521. [PMID: 32451748 DOI: 10.1007/s10561-020-09838-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 05/15/2020] [Indexed: 10/24/2022]
Abstract
In this experimental study we used for the first time Tiprotec® as a solution for corneal preservation and cold storage. We compared the resultant endothelial cell morphology and viability with this obtained after preservation of the ex-vivo corneas with both usual standard techniques: conventional cold storage (using Eusol-C) and organ culture. This prospective, in vitro, 3-armed parallel study was performed with the use of 90 porcine corneas (examined for their endothelial quality and transparency) randomly selected for preservation in three storage methods (each 30 corneas): organ culture, standard cold storage (Eusol-C) and experimental cold storage (Tiprotec®) Endothelium cell quantity and quality as well as corneal opacification were assessed. The degree of endothelial transparency was significantly reduced over time with all preservation media, without any significant difference among the three groups at any point of time. A reduction in endothelial cell density was also observed with all three preservation media after 30 days of storage without statistically significant differences between groups. The number of hexagonal and pentagonal endothelium cells was significantly reduced overtime in all media with significantly more hexagonal and pentagonal in the organ culture group compared to the cold storage groups. We could show that the cryopreservation medium Tiprotec®, used until now for the preservation of vascular grafts, was of similar quality compared to the medium Eusol-C for the hypothermic storage of corneal tissue for an extended period of time up to 30 days. In comparison to organic culture with culture medium KII, both Tiprotec® and Eusol-C were found less effective in preserving endothelial cell quality, as assessed by the morphometric analysis, and viability, as assessed by the degree of vacuolization at least up to the 30th day of storage. However, both, Tiprotec®- and Eusol-C-preserved corneas demonstrated a certain capacity to recover after their submission in organ culture.
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Jullienne R, Garcin T, Crouzet E, He Z, Renault D, Thuret G, Gain P. Evaluation of corneal epithelial wound healing after penetrating keratoplasty in patients receiving a new matrix therapy agent (regenerating agent). Eur J Ophthalmol 2018; 30:119-124. [PMID: 30378440 DOI: 10.1177/1120672118808971] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Complete epithelial wound healing is a milestone in early postoperative care after penetrating keratoplasty. The re-epithelialization rate after penetrating keratoplasty was measured in patients receiving a new matrix therapy agent (regenerating agent, Cacicol®) that mimics heparan sulphates. METHODS This was a prospective, open-label, uncontrolled, single-centre observational study. A total of 33 consecutive patients (33 eyes) who underwent an 8.25-mm diameter penetrating keratoplasty were treated with regenerating agent eye drops: one drop in the operating theatre immediately after graft, then on alternate days. Patients were divided into those at low risk (13 patients) and high risk (20 patients) of delayed wound healing, and follow-up was performed by digital slit lamp with fluorescein-dye testing repeated daily at a fixed time. Dye area was measured using ImageJ freeware. The main endpoint was epithelial healing after regenerating agent therapy. RESULTS The mean ± standard deviation time to complete healing for all patients was 2.7 ± 1.1 (median: 3, range: 1-6) days. This was obtained on Day 1 for 15% of patients, Day 2 for 33%, Day 3 for 88%, Day 4 for 94% and Day 6 for 100%. There was no significant difference between low- and high-risk patients. The area of epithelial defect decreased by a mean ± standard deviation of 75% ± 22% between Day 1 and Day 2, corresponding to a mean ± standard deviation wound-healing rate of 11.5 ± 6.5 mm2/D. There were no systemic or local side effects related to regenerating agent. CONCLUSION These preliminary data suggest that regenerating agent could be a useful, non-invasive therapeutic approach in postoperative management of penetrating keratoplasty with the potential to accelerate re-epithelialization.
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Affiliation(s)
- Rémy Jullienne
- Department of Ophthalmology, University Hospital of Saint-Etienne, Saint-Etienne, France.,Corneal Graft Biology, Engineering and Imaging Laboratory, EA2521, IFR 143, Federative Institute of Research in Sciences and Health Engineering, Faculty of Medicine, Jean Monnet University, Saint-Etienne, France
| | - Thibaud Garcin
- Department of Ophthalmology, University Hospital of Saint-Etienne, Saint-Etienne, France.,Corneal Graft Biology, Engineering and Imaging Laboratory, EA2521, IFR 143, Federative Institute of Research in Sciences and Health Engineering, Faculty of Medicine, Jean Monnet University, Saint-Etienne, France
| | - Emmanuel Crouzet
- Corneal Graft Biology, Engineering and Imaging Laboratory, EA2521, IFR 143, Federative Institute of Research in Sciences and Health Engineering, Faculty of Medicine, Jean Monnet University, Saint-Etienne, France
| | - Zhiguo He
- Corneal Graft Biology, Engineering and Imaging Laboratory, EA2521, IFR 143, Federative Institute of Research in Sciences and Health Engineering, Faculty of Medicine, Jean Monnet University, Saint-Etienne, France
| | - Didier Renault
- Corneal Graft Biology, Engineering and Imaging Laboratory, EA2521, IFR 143, Federative Institute of Research in Sciences and Health Engineering, Faculty of Medicine, Jean Monnet University, Saint-Etienne, France.,Laboratoires Théa, Clermont-Ferrand, France
| | - Gilles Thuret
- Department of Ophthalmology, University Hospital of Saint-Etienne, Saint-Etienne, France.,Corneal Graft Biology, Engineering and Imaging Laboratory, EA2521, IFR 143, Federative Institute of Research in Sciences and Health Engineering, Faculty of Medicine, Jean Monnet University, Saint-Etienne, France.,Institut Universitaire de France, Paris, France
| | - Philippe Gain
- Department of Ophthalmology, University Hospital of Saint-Etienne, Saint-Etienne, France.,Corneal Graft Biology, Engineering and Imaging Laboratory, EA2521, IFR 143, Federative Institute of Research in Sciences and Health Engineering, Faculty of Medicine, Jean Monnet University, Saint-Etienne, France
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12
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Mamikonyan VR, Osipyan GA, Doguzov VA, Rozinova VN, Shchukina TI, Khraystin K. [Objective assessment of donor material for penetrating corneal transplantation]. Vestn Oftalmol 2018; 133:76-82. [PMID: 29319672 DOI: 10.17116/oftalma2017133676-82] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Reliable suitability evaluation of donor material is the crucial issue of penetrating corneal transplantation. The main parameter to be considered is endothelial cell density (ECD). However, when it comes to practice, one has to admit significant variation in ECD readings of cadaver corneas obtained by different methods. AIM to investigate discrepancies in ECD measurements and to define objective criteria for the evaluation of a donor cornea before full-thickness grafting. MATERIAL AND METHODS In a hundred cadaver eyes, discrepancies in ECD measurements by different methods (specular microscopy, confocal microscopy, and keratoanalyzer) were studied and objective evaluation criteria developed along with an optimal algorithm of pretransplantation assessment. Digital fluorescence microscopy was chosen as the reference method. RESULTS It has been established that a triple measurement average obtained with any of the tested methods is informative enough as to the state of the donor cornea. CONCLUSION The highest ECD values were obtained with specular microscopy, the lowest - with confocal microscopy. For reliable evaluation of donor corneas, we recommend that the average of a triple ECD measurement be taken using one of the mentioned methods.
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Affiliation(s)
- V R Mamikonyan
- Research Institute of Eye Diseases, 11 A, B, Rossolimo St., Moscow, Russian Federation, 119021
| | - G A Osipyan
- Research Institute of Eye Diseases, 11 A, B, Rossolimo St., Moscow, Russian Federation, 119021
| | - V A Doguzov
- Research Institute of Eye Diseases, 11 A, B, Rossolimo St., Moscow, Russian Federation, 119021
| | - V N Rozinova
- Research Institute of Eye Diseases, 11 A, B, Rossolimo St., Moscow, Russian Federation, 119021
| | - T I Shchukina
- Research Institute of Eye Diseases, 11 A, B, Rossolimo St., Moscow, Russian Federation, 119021
| | - Kh Khraystin
- Research Institute of Eye Diseases, 11 A, B, Rossolimo St., Moscow, Russian Federation, 119021
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Kapur N, Gunda S, Dixit S, Chauhan L, Acharya M, Mathur U. Effect of transfer of donor corneal tissue from McCarey-Kaufmann medium to Optisol-GS on corneal endothelium. Indian J Ophthalmol 2018; 66:219-222. [PMID: 29380761 PMCID: PMC5819098 DOI: 10.4103/ijo.ijo_677_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Purpose: The purpose of this study is to evaluate the effect of transfer of donor corneal tissue from McCarey–Kaufmann (MK) medium to Optisol-GS on corneal endothelium. Methods: This was a prospective, randomized comparative study. Twenty paired human donor corneal tissues of optical quality were retrieved. One tissue of the pair was preserved in Optisol-GS preservative medium (Group A) and other tissue of the pair in MK medium (Group B) at the time of corneoscleral disc excision. Within 12 h of retrieval, each cornea was evaluated using slit-lamp biomicroscopic examination and specular microscopic analysis. Group B corneas were transferred to Optisol-GS medium within 48–53 h of retrieval. Specular analysis of the paired corneas was repeated 3 h after transferring to Optisol-GS. On day 7 of storage, specular analysis of both the tissues was repeated. Results: The average age of the donor at the time of death was 29 years (16–68 years). The reduction in endothelial cell count, from baseline, in Groups A and B was 5.5% and 5.8% (P = 0.938) on the 3rd day and 8.2% and 12.6% (P = 0.025) on the 7th day, respectively, postretrieval. The coefficient of variation (CV) increased by 36% (P = 0.021) and hexagonality reduced by 19% (P = 0.007) on day 7. All tissues retained an endothelial cell density higher than the accepted critical level for penetrating keratoplasty. Conclusion: Significant endothelial cell loss was noted while transferring tissues from one medium to another, necessitating the need for reevaluation of transferred tissues before utilization.
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Affiliation(s)
- Neha Kapur
- Dr. Shroff 's Charity Eye Hospital, New Delhi, India
| | - Sridevi Gunda
- Dr. Shroff 's Charity Eye Hospital, New Delhi, India
| | | | | | | | - Umang Mathur
- Dr. Shroff 's Charity Eye Hospital, New Delhi, India
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Thieme D, Reuland L, Lindl T, Kruse F, Fuchsluger T. Optimized human platelet lysate as novel basis for a serum-, xeno-, and additive-free corneal endothelial cell and tissue culture. J Tissue Eng Regen Med 2017; 12:557-564. [PMID: 28941176 DOI: 10.1002/term.2574] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 08/04/2017] [Accepted: 09/12/2017] [Indexed: 01/02/2023]
Abstract
The expansion of donor-derived corneal endothelial cells (ECs) is a promising approach for regenerative therapies in corneal diseases. To achieve the best Good Manufacturing Practice standard the entire cultivation process should be devoid of nonhuman components. However, so far, there is no suitable xeno-free protocol for clinical applications. We therefore introduce a processed variant of a platelet lysate for the use in corneal cell and tissue culture based on a Good Manufacturing Practice-grade thrombocyte concentrate. This processed human platelet lysate (phPL), free of any animal components and of anticoagulants such as heparin with a physiological ionic composition, was used to cultivate corneal ECs in vitro and ex vivo in comparison to standard cultivation with fetal calf serum (FCS). Human donor corneas were cut in quarters while 2 quarters of each cornea were incubated with the respective medium supplement. Three fields of view per quarter were taken into account for the analysis. Evaluation of phPL as a medium supplement in cell culture of immortalized EC showed a superior viability compared with FCS control with reduced cell proliferation. Furthermore, the viability during the expansion of primary cells is significantly (3-fold ±0.5) increased with phPL compared with FCS standard medium. Quartering donor corneas was traumatic for the endothelium and therefore resulted in increased EC loss. Interestingly, however, cultivation of the quartered pieces for 2 weeks in 0.1-mg/ml pHPL in Biochrome I showed a 21 (±10) % EC loss compared with 67 (±12) % EC loss when cultivated in 2% FCS in Biochrome I. The cell culture protocol with pHPL as FCS replacement seems to be superior to the standard FCS protocols with respect to EC survival. It offers a xeno-free and physiological environment for corneal endothelial cells. This alternative cultivation protocol could facilitate the use of EC for human corneal cell therapy.
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Affiliation(s)
- Daniel Thieme
- Department of Ophthalmology, Universitätsklinikum Erlangen/Nürnberg; Augenklinik, Erlangen, Germany
| | - Lynn Reuland
- Department of Ophthalmology, Universitätsklinikum Erlangen/Nürnberg; Augenklinik, Erlangen, Germany
| | - Toni Lindl
- Institute of Applied Cell Culture, I-A-Z GmbH, Munich, Germany
| | - Friedrich Kruse
- Department of Ophthalmology, Universitätsklinikum Erlangen/Nürnberg; Augenklinik, Erlangen, Germany
| | - Thomas Fuchsluger
- Department of Ophthalmology, Universitätsklinikum Erlangen/Nürnberg; Augenklinik, Erlangen, Germany
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Kitazawa K, Inatomi T, Tanioka H, Kawasaki S, Nakagawa H, Hieda O, Fukuoka H, Okumura N, Koizumi N, Iliakis B, Sotozono C, Kinoshita S. The existence of dead cells in donor corneal endothelium preserved with storage media. Br J Ophthalmol 2017; 101:1725-1730. [DOI: 10.1136/bjophthalmol-2017-310913] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 07/17/2017] [Accepted: 08/13/2017] [Indexed: 12/18/2022]
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Roberts HW, Mukherjee A, Aichner H, Rajan MS. Visual Outcomes and Graft Thickness in Microthin DSAEK—One-Year Results. Cornea 2015; 34:1345-50. [DOI: 10.1097/ico.0000000000000596] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Yüksel B, Uzunel UD, Küsbeci T. Endothelial Cell Viability of Donor Corneas Preserved in Eusol-C Corneal Storage Medium. EXP CLIN TRANSPLANT 2015; 14:441-4. [PMID: 26476102 DOI: 10.6002/ect.2014.0295] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES To evaluate the efficacy of Eusol-C as a corneal storage medium on the survival of donor endothelium. MATERIALS AND METHODS Twenty-seven corneas not suitable for transplant were included in this study. All donor corneas were stored in Eusol-C at 4°C. Daily donor corneal endothelial cell counting was performed with an eye bank specular microscope. All corneas were discarded after the study process. RESULTS Mean donor age was 51.3 ± 18.8 years (range, 25-94 y). The mean duration between death and corneal excision was 9.5 ± 6.7 hours (range, 3-23 h). Mean endothelial cell density was 2195 ± 383 cells/mm² at the beginning of the preservation (range, 1361-2899 cells/mm²). Donor endothelial cell density was between 1500 to 2000 cells/mm² in 9 corneas, 2000 to 2500 in 11 corneas, 2500 to 3000 in 5, and higher than 3000 in 2 corneas at baseline. Mean endothelial cell density was found 1658 cells/mm² on the eighth day of storage, with a mean endothelial cell loss rate of 24.5%. Corneas stored 9 to 24 days in Eusol-C had a rate of endothelial cell damage of 3.1% per day. CONCLUSIONS Although our results revealed a higher endothelial cell loss than previous reports, overall performance of Eusol-C in preserving the donor endothelium may be satisfactory for clinical use.
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Affiliation(s)
- Bora Yüksel
- From the Izmir Bozyaka Training and Research Hospital, Department of Ophthalmology, Saim Çıkrıkçı Cd. No:59 Bozyaka, Izmir, Turkey
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Abstract
PURPOSE The aim of this study was to report the incidence of epithelial defects and identify donor factors that might correlate with the presence of epithelial defects and graft reepithelialization time after a deep anterior lamellar keratoplasty (DALK). METHODS In this retrospective study, 283 consecutive keratoconic eyes underwent DALK using donor corneas of different qualities, ranging from fair to excellent. The donor data included age and sex, cause of death, death-to-preservation time, preservation-to-surgery time, epithelial and stromal status, endothelial cell density and morphology, and graft rating. On the first postoperative day, the corneal surface was carefully examined before and after the application of fluorescein stain, and the patients were followed up daily until complete reepithelialization occurred. A multivariate regression analysis was used to assess the correlation between donor characteristics and graft epithelial defects on postoperative day 1. RESULTS The mean donor and recipient ages were 33.5 ± 13.2 and 27.6 ± 7.9 years, respectively. Two hundred sixty-four (93.3%) grafts had epithelial defects on day 1. The epithelial defects completely healed after 3.5 ± 2.7 (range, 1-37) days. In the univariate analysis, the presence of epithelial defects on postoperative day 1 had a significant correlation with donor preservation-to-surgery time (P = 0.01), epithelial sloughing (P < 0.001), and graft rating (P = 0.004). In the multivariate analysis, only donor epithelial sloughing significantly influenced the presence of epithelial defects on postoperative day 1 (odds ratio = 9.26, P < 0.001). CONCLUSIONS Graft epithelial defects were very common after DALK. The epithelial status of donors was the only independent factor predictive of the surface integrity on the first postoperative day.
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Lam DKT, Chan TCY, Wong JSC, Chow GY, Wong VWY. The Association of Delayed Corneal Surface and Visual Recovery After Corneal Transplantation With Longer Donor Storage Time-A Prospective Analysis. Asia Pac J Ophthalmol (Phila) 2014; 3:211-4. [PMID: 26107759 DOI: 10.1097/apo.0000000000000008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
PURPOSE This study aimed to assess the influence of donor corneal storage time on endothelial cell count (ECC), corneal epithelial recovery, and visual rehabilitation after corneal transplantation in the first postoperative year. DESIGN A collaborative prospective study involving a local eye bank and a tertiary ophthalmic unit was conducted. METHODS Donor cornea buttons were stored in Optisol-GS (Chiron Ophthalmics Inc, Irvine, Calif) storage media for a maximum of 14 days before transplantation. Before corneal distribution, the eye bank collected information on death-to-harvesting time, death-to-surgery time, donor central corneal thickness, and donor ECC at various time points. Subjects who underwent penetrating keratoplasty and endothelial keratoplasty were recruited and monitored for 1 year. Postoperative epithelial healing, visual acuity, ECC, and hospital stay were evaluated. RESULTS Thirty-one eyes of 31 patients completed the study. There was a significant positive correlation between donor storage time and epithelial healing (Spearman ρ = 0.39, P = 0.031). Faster epithelial healing was significantly correlated with posttransplantation visual improvements at months 1, 3, and 6 and shorter hospital stay (Spearman ρ = 0.74, P < 0.001). Mean ECC loss was 23.8% at 12 months posttransplantation. There was no significant correlation between storage time and ECC loss preoperatively and posttransplantation. CONCLUSIONS The duration of graft storage in Optisol-GS storage media up to 14 days had no significant effects on long-term visual acuity and ECC postoperatively. Shorter storage time had significant correlation with earlier epithelial healing and faster visual rehabilitation.
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Affiliation(s)
- Douglas K T Lam
- From the *Hospital Authority Ophthalmic Service, Hong Kong Eye Hospital, Hong Kong SAR, China; and †Hospital Authority Lion's Eye Bank, Hong Kong SAR, China
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Lai T, Tang S. Cornea characterization using a combined multiphoton microscopy and optical coherence tomography system. BIOMEDICAL OPTICS EXPRESS 2014; 5:1494-511. [PMID: 24877011 PMCID: PMC4026894 DOI: 10.1364/boe.5.001494] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 03/30/2014] [Accepted: 04/04/2014] [Indexed: 05/17/2023]
Abstract
We present a multimodal imaging system which combines multiphoton microscopy and optical coherence tomography to visualize the morphological structures, and to quantify the refractive index (RI) and thickness of cornea. The morphological similarities and differences at different corneal layers across various species are identified. In the piscine and human corneas, the stromata exhibit thin fibers that indicate an overall collagen direction. Human corneas display collagen micro-folds which cause increased light attenuation. In the murine, porcine and bovine corneas, the stromata show interwoven collagen patterns. The Bowman's layer and the Descemet's membrane are also distinguished in some species. The RI and thicknesses are quantified for the epithelium and the stromal layers respectively, where the epithelium is found to have slightly higher RI than the stroma. The average epithelial and stromal RI are, respectively, 1.371 ± 0.016 and 1.360 ± 0.008 for the murine corneas; 1.502 ± 0.057 and 1.335 ± 0.011 for the piscine corneas; 1.433 ± 0.023 and 1.357 ± 0.013 for the human corneas; 1.476 ± 0.091 and 1.343 ± 0.013 for the porcine corneas; and 1.400 ± 0.007 and 1.376 ± 0.003 for the bovine corneas. The multimodal system can potentially provide a comprehensive characterization of the cornea.
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Xu L, Knox WH, DeMagistris M, Wang N, Huxlin KR. Noninvasive intratissue refractive index shaping (IRIS) of the cornea with blue femtosecond laser light. Invest Ophthalmol Vis Sci 2011; 52:8148-55. [PMID: 21931133 DOI: 10.1167/iovs.11-7323] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
PURPOSE To test the feasibility of intratissue refractive index shaping (IRIS) in living corneas by using 400-nm femtosecond (fs) laser pulses (blue-IRIS). To test the hypothesis that the intrinsic two-photon absorption of the cornea allows blue-IRIS to be performed with greater efficacy than when using 800-nm femtosecond laser pulses. METHODS Fresh cat corneas were obtained postmortem and cut into six wedges. Blue laser pulses at 400 nm, with 100-fs pulse duration at 80 MHz were used to micromachine phase gratings into each corneal wedge at scanning speeds from 1 to 15 mm/s. Grating lines were 1 μm wide, 5 μm apart, and 150 μm below the anterior corneal surface. Refractive index (RI) changes in micromachined regions were measured immediately by recording the diffraction efficiency of inscribed gratings. Six hours later, the corneas were processed for histology, and TUNEL staining was performed to assess whether blue-IRIS causes cell death. RESULTS Scanning at 1 and 2 mm/s caused overt corneal damage in the form of bubbles and burns. At faster scanning speeds (5, 10, and 15 mm/s), phase gratings were created in the corneal stroma, which were shown to be pure RI changes ranging from 0.037 to 0.021 in magnitude. The magnitude of RI change was inversely related to scanning speed. TUNEL staining showed cell death only around bubbles and burns. CONCLUSIONS Blue-IRIS can be performed safely and effectively in living cornea. Compared with near-infrared laser pulses, blue-IRIS enhances both achievable RI change and scanning speed without the need to dope the tissue with two-photon sensitizers, increasing the clinical applicability of this technique.
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Affiliation(s)
- Lisen Xu
- The Institute of Optics, University of Rochester, Rochester, New York, USA
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Koh SWM, Gloria D, Molloy J. Corneal endothelial autocrine VIP enhances its integrity in stored human donor corneoscleral explant. Invest Ophthalmol Vis Sci 2011; 52:5632-40. [PMID: 21482640 DOI: 10.1167/iovs.10-5983] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To demonstrate corneal endothelial (CE) integrity enhanced during eye banking by a brief treatment of human donor corneoscleral explant (explant) with CE autocrine trophic factor vasoactive intestinal peptide (VIP). METHODS Paired explants were used as control versus VIP (10 nM)-treated before storage in corneal storage medium (4°C). CE ciliary neurotrophic factor receptor (CNTFRα) and CNTF (0.83 nM) responsiveness in connexin 43 upregulation were monitored (Western blot analysis). CE damage in CNTF-modulated explants and corneal buttons from explants was quantified by analysis of panoramic and microscopic images of the alizarin red-stained corneal endothelium. CE cells scraped from the Descemet's membrane were counted. CE VIP receptor was demonstrated (Western blot analysis). RESULTS CE cells in every VIP-treated, freshly dissected explant demonstrated higher CNTFRα levels than controls (100% vs. 142% ± 15%; P = 0.014; 7 pairs stored for 4 to 25 days). Nine days after VIP treatment of previously preserved explants, CNTF responsiveness was 174% ± 23% (P = 0.023; 4 pairs) of controls. Panoramic images of explants and corneal buttons revealed that VIP treatment reduced CE damage to 75% ± 6% (P = 0.023; 4 pairs) and 71% ± 11% (P = 0.016; 9 pairs) of controls, respectively, whereas CE damage to 39% (2 pairs) and 23% ± 4% (P < 0.001; 7 pairs), respectively, was revealed in microscopic images. Twenty-one days after VIP treatment of previously preserved explants, CE cell retention was 206% ± 38% (P = 0.008; 14 pairs) of the control. CE cells from human donor corneas expressed VIP receptor VPAC1 (not VPAC2). CONCLUSIONS CE integrity during eye banking was enhanced by a brief treatment of the explant with the CE autocrine VIP.
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Affiliation(s)
- Shay-Whey M Koh
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, 10 S. Pine Street, Baltimore, MD 21201, USA.
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Laaser K, Bachmann BO, Horn FK, Schlötzer-Schrehardt U, Cursiefen C, Kruse FE. Donor tissue culture conditions and outcome after descemet membrane endothelial keratoplasty. Am J Ophthalmol 2011; 151:1007-1018.e2. [PMID: 21334592 DOI: 10.1016/j.ajo.2010.11.027] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2010] [Revised: 11/22/2010] [Accepted: 11/22/2010] [Indexed: 10/18/2022]
Abstract
PURPOSE To investigate the effect of culture conditions of donor tissue on functional outcome after Descemet membrane endothelial keratoplasty. DESIGN Retrospective, single-center, consecutive case series. METHODS Descemet membrane endothelial keratoplasty was performed routinely in 82 eyes of 82 consecutive patients using corneal donor tissue prestored in either short-term culture (Optisol-GS; Bausch & Lomb) at 4 C (group A; n = 37) or organ culture (Dulbecco Modified Eagle Medium [Biochrom]; CorneaMax Medium [Eurobio]) at 34 C (group B; n = 45) in a randomized fashion. Main outcome measures included the number of air injections necessary for graft attachment as well as best-corrected visual acuity (in logarithm of the minimal angle of resolution [logMAR] units), central corneal thickness, and endothelial cell density at 1, 3, and 6 months after surgery. RESULTS Best-corrected visual acuity increased from 0.69 ± 0.53 logMAR and 0.67 ± 0.31 logMAR before surgery to 0.33 ± 0.21 logMAR and 0.28 ± 0.18 logMAR after 1 month (P < .05), to 0.24 ± 0.16 logMAR and 0.18 ± 0.16 logMAR after 3 months (P < .05), and to 0.18 ± 0.12 logMAR and 0.15 ± 0.10 logMAR after 6 months (n.s.) in groups A and B, respectively. Endothelial cell density decreased from 2647 ± 236 cells/mm(2) and 2515 ± 249 cells/mm(2) before surgery to 1499 ± 277 cells/mm(2) and 1526 ± 205 cells/mm(2) after 1 month (P < .05), to 1441 ± 213 cells/mm(2) and 1443 ± 316 cells/mm(2) after 3 months (n.s.), and to 1587 ± 366 cells/mm(2) and 1457 ± 285 cells/mm(2) after 6 months (n.s.) in groups A and B, respectively. Central corneal thickness declined from 664 ± 89 and 662 ± 107 μm before surgery to 529 ± 92 μm and 517 ± 62 μm after 1 month (P < .05), to 511 ± 46 μm and 510 ± 46 μm after 3 months (P < .05), and to 529 ± 68 μm and 507 ± 50 μm after 6 months (n.s.) in groups A and B, respectively. Best-corrected visual acuity, endothelial cell density, and central corneal thickness values showed no significant differences between both groups at any time point after surgery. However, a significantly higher total number of air injections was necessary in group A (n = 34) compared with group B (n = 26) to obtain graft attachment (P < .05). CONCLUSIONS These findings suggest that donor tissue culture conditions have no significant effect on functional outcome, but may influence graft adhesion and rebubbling rate after Descemet membrane endothelial keratoplasty surgery.
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Corwin WL, Baust JM, Baust JG, Van Buskirk RG. The unfolded protein response in human corneal endothelial cells following hypothermic storage: implications of a novel stress pathway. Cryobiology 2011; 63:46-55. [PMID: 21549109 DOI: 10.1016/j.cryobiol.2011.04.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2010] [Revised: 04/15/2011] [Accepted: 04/20/2011] [Indexed: 01/22/2023]
Abstract
Human corneal endothelial cells (HCEC) have become increasingly important for a range of eye disease treatment therapies. Accordingly, a more detailed understanding of the processing and preservation associated stresses experienced by corneal cells might contribute to improved therapeutic outcomes. To this end, the unfolded protein response (UPR) pathway was investigated as a potential mediator of corneal cell death in response to hypothermic storage. Once preservation-induced failure had begun in HCECs stored at 4°C, it was noted that necrosis accounted for the majority of cell death but with significant apoptotic involvement, peaking at several hours post-storage (4-8h). Western blot analysis demonstrated changes associated with apoptotic activation (caspase 9, caspase 3, and PARP cleavage). Further, the activation of the UPR pathway was observed through increased and sustained levels of ER folding and chaperone proteins (Bip, PDI, and ERO1-Lα) in samples experiencing significant cell death. Modulation of the UPR pathway using the specific inhibitor, salubrinal, resulted in a 2-fold increase in cell survival in samples experiencing profound cold-induced failure. Furthermore, this increased cell survival was associated with increased membrane integrity, cell attachment, and decreased necrotic cell death populations. Conversely, addition of the UPR inducer, tunicamycin, during cold exposure resulted in a significant decrease in HCEC survival during the recovery period. These data implicate for the first time that this novel cell stress pathway may be activated in HCEC as a result of the complex stresses associated with hypothermic exposure. The data suggest that the targeted control of the UPR pathway during both processing and preservation protocols may improve cell survival and function of HCEC thus improving the clinical utility of these cells as well as whole human corneas.
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Affiliation(s)
- William L Corwin
- Institute of Biomedical Technology, Binghamton University, NY 13902, USA
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Cui L, Huxlin KR, Xu L, MacRae S, Knox WH. High-resolution, noninvasive, two-photon fluorescence measurement of molecular concentrations in corneal tissue. Invest Ophthalmol Vis Sci 2011; 52:2556-64. [PMID: 21228379 DOI: 10.1167/iovs.10-6620] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To perform high-resolution, noninvasive, calibrated measurements of the concentrations and diffusion profiles of fluorescent molecules in the live cornea after topical application to the ocular surface. METHODS An 800-nm femtosecond laser was used to perform two-photon fluorescence (TPF) axial scanning measurements. Calibration solutions consisting of sodium fluorescein (Na-Fl; concentration range, 0.01%-2.5%) and riboflavin (concentration range, 0.0125%-0.1%) were tested in well slides, and TPF signals were assessed. Excised feline eyeballs preserved in corneal storage medium and with either intact or removed corneal epithelia were then treated with Na-Fl, riboflavin, or fluorescein dextran (Fl-d) of different molecular weight (MW) for 30 minutes. Calibrated TPF was then used immediately to measure the concentration of these molecules across the central corneal depth. RESULTS The axial resolution of our TPF system was 6 μm, and a linear relationship was observed between TPF signal and low concentrations of most fluorophores. Intact corneas treated with Na-Fl or riboflavin exhibited a detectable penetration depth of only approximately 20 μm, compared with approximately 400 to 600 μm when the epithelium was removed before fluorophore application. Peak concentrations for intact corneas were half those attained with epithelial removal. Debrided corneas treated with 2,000,000 MW Fl-d showed a half-maximum penetration depth of 156.7 μm compared with 384 μm for the 3,000 MW dextran. The peak concentration of the high MW dextran was one quarter that of the lower MW dextran. CONCLUSIONS TPF is an effective, high-resolution, noninvasive method of quantifying the diffusion and concentration of fluorescent molecules across the cornea.
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Affiliation(s)
- Liping Cui
- Institute of Optics, University of Roichester, Rochester, NY, USA
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Kobayakawa S, Hiratsuka Y, Watabe Y, Murakami A, Tochikubo T. Comparison of the influence of intracameral gentamicin, gatifloxacin, and moxifloxacin on the corneal endothelium in a rabbit model. Jpn J Ophthalmol 2010; 54:481-5. [PMID: 21052913 DOI: 10.1007/s10384-010-0838-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Accepted: 04/13/2010] [Indexed: 10/18/2022]
Abstract
PURPOSE To compare the effect of three intracameral antibiotics, gentamicin (GM), gatifloxacin (GFLX), and moxifloxacin (MFLX), on the rabbit corneal endothelium. METHODS Twenty-four eyes from 18 rabbits were used. In the GM treatment group of 12 eyes, a dose of 20 mg/ml, 2 mg/ml, 200 μg/ml, or 20 μg/ml of GM was injected into the anterior chamber. In the GFLX and MFLX treatment groups were injected into the anterior chamber of three eyes. The central corneal thickness was measured. The eyes were then enucleated for observation under scanning electron microscopy. RESULTS Three days after the intracameral injection, a significant difference in central corneal thickness was found between the GM 20 mg/ml group and the control group (P < 0.05), but not between any other groups. The damage rate at the endothelial cell level was 67% in the GM 20 mg/ml group, 56% in the GM 2 mg/ml group, 33% in the GM 200 μg/ml group, 22% in the GM 20 μg/ml group, 22% in the GFLX group, and 0% in the MFLX group. CONCLUSIONS Intracameral GFLX or MFLX was almost nontoxic to the rabbit corneal endothelium, in contrast to the toxic results of intracameral GM 20 and 2 mg/ml.
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Chéour M, Nasri H, Kamoun H, Lamloum H, Kasri A, Hamdi S, Kraiem A. Les facteurs intervenant dans la réépithélialisation cornéenne après kératoplastie transfixiante. J Fr Ophtalmol 2008; 31:786-9. [DOI: 10.1016/s0181-5512(08)74398-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
PURPOSE OF REVIEW The aim of this article is to review the recent literature regarding corneal storage media since the last review that discussed this topic in substantial detail in this journal. RECENT FINDINGS During the last few years, despite the development of new corneal storage media and the addition of new additives to established corneal storage media, Optisol GS (Bausch & Lomb, Irvine, California, USA) has continued to remain the popular choice among storage media used in the United States, and traditional organ culture methods are still used in Europe. Recognizing that persistent epithelial defects after corneal transplantation can be a serious complication, however, attention has started to focus on not only preserving the endothelium, but also the epithelium. In addition, there has been more research towards antimicrobial prophylaxis. SUMMARY With recent evidence suggesting that longer storage times may allow better outcomes in high-risk grafts because of the depletion of donor T cells from the donor cornea into the storage media, storage media will need to be optimized for preserving the endothelium for longer periods of time. In addition, because the epithelium is typically unable to be sustained for longer than 1 week in storage media, research toward preserving the epithelium will also be essential.
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Affiliation(s)
- Bennie H Jeng
- Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
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Baust JM. Molecular Mechanisms of Cellular Demise Associated with Cryopreservation Failure. ACTA ACUST UNITED AC 2002. [DOI: 10.1089/15383440260073266] [Citation(s) in RCA: 82] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- John M. Baust
- Center for Engineering and Medicine, Harvard Medical School, Massachusetts General Hospital and Shriners Hospital for Children, Boston, Massachusetts
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Jeng BH, Meisler DM, Hollyfield JG, Connor JT, Aulak KS, Stuehr DJ. Nitric oxide generated by corneas in corneal storage media. Cornea 2002; 21:410-4. [PMID: 11973392 DOI: 10.1097/00003226-200205000-00015] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of the study was to quantify nitric oxide release by human corneal buttons in storage media over time. METHODS Group 1 consisted of six chambers of Optisol GS corneal storage media, each containing a viable human corneal button with an attached scleral rim (unsuitable for transplantation), sampled at 1-day intervals for at least 17 days (range, 17-28 days). Group 2 consisted of 34 chambers of Optisol GS media, each used to store a corneal button for penetrating keratoplasty, sampled immediately after each surgery. An unused vial of Optisol GS storage medium was sampled daily for 17 days to serve as a background medium control. The total amount of nitrite and nitrate in each sample was determined by a spectrophotometric method based on the Griess reaction. RESULTS Data from the daily sampling in group 1 showed that nitrite and nitrate concentrations in storage media containing human corneas increase from a baseline level (beginning at the time the corneas are placed in the media) to an equilibrium concentration of 2.77 microM in a mean time of 6.15 days. Seventy-six percent of the data points from group 2 fell within the 80% predictive interval derived from group 1. No nitrite or nitrate was detected in background medium control samples. CONCLUSION The progressive increase in nitrite and nitrate in corneal storage media over time suggests that nitric oxide is continuously released by corneas during storage before transplantation. Given the toxic free radical properties of nitric oxide, corneas in storage media may be subjected to the cumulative toxic effects of nitric oxide.
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Affiliation(s)
- Bennie H Jeng
- Cole Eye Institute, The Cleveland Clinic Foundation, Ohio 44195, USA
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Bourne WM, Nelson LR, Maguire LJ, Baratz KH, Hodge DO. Comparison of Chen Medium and Optisol-GS for human corneal preservation at 4 degrees C: results of transplantation. Cornea 2001; 20:683-6. [PMID: 11588417 DOI: 10.1097/00003226-200110000-00003] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare results after transplantation of donor corneas stored in Chen Medium (containing beta-hydroxybutyrate without sodium bicarbonate or chondroitin sulfate) to corneas stored in Optisol-GS medium (containing sodium bicarbonate and 2.5% chondroitin sulfate). METHODS We performed 32 consecutive penetrating keratoplasties with donor corneas stored at 4 degrees C in either Chen Medium or Optisol-GS by random assignment. Corneal thickness measurements were made at 1 day, 1 week, 3 weeks, 2 months, and 1 year postkeratoplasty. Specular microscopic images of the donor endothelium were obtained at the beginning of storage and 2 months and 1 year postkeratoplasty. The percentage of intact epithelium 1 day after keratoplasty and the graft epithelialization time were estimated by the surgeons. Donor rim cultures were performed. RESULTS No statistically significant differences in corneal thickness or endothelial cell loss between the corneas stored in the two media were found at any time, although differences of less than 12% cell loss or 0.09-mm thickness at 2 months or less than 25% cell loss or 0.10-mm thickness at 1 year could not be excluded with 90% certainty in this small series. The mean percentages of intact graft epithelium on day 1, 64% for Chen Medium and 65% for Optisol-GS, were not significantly different. Endothelial cell density 2 months postkeratoplasty was significantly decreased for corneas stored in both media. Endothelial cell loss at 2 months was directly correlated with storage time in both media. CONCLUSIONS After keratoplasty, no statistically significant differences in corneal thickness, epithelial survival, and endothelial cell loss were found between corneas stored in Chen Medium and Optisol-GS. Endothelial cell loss at 2 months was significantly correlated with storage time in both media.
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Affiliation(s)
- W M Bourne
- Department of Ophthalmology, Mayo Clinic and Foundation, 200 First Street SW, Rochester, Minnesota 55905, U.S.A.
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