Evaluation of donor corneal endothelial cells on eye bank specular microscope

Abstract

Abstract
Background: Proper evaluation of donor cornea is critical, in deciding the quality of cornea, and thereby to the success of transplantation. With the advent of slit lamp bio-microscopy, and specular microscopy, and with its further availability as an eye bank model, this has become possible. Having known the importance of, and therefore by studying, the endothelium of the donor tissue by doing the specular microscopy with the help of eye bank specular microscope, we can greatly and favourably influence the number of tissues which can be used for various transplant surgeries and make an objective difference to the quality of donor tissues made available for transplantation.
Materials and methodology: A prospective randomised study was carried out from October 2011 to December 2013 at Shri C.H. Nagri eye institute. In this study63 donor eyes were processed and analysed at the eye bank in our institute. After evaluation by slitlamp examination tissue were given a clinical grade ranging from excellent to poor.
Obeservations and Results :The study analyzed 63 donor eyes aged 19–84 years, with most donors between 41–80 years. As age increased, endothelial cell density (CD) generally declined, though many older tissues retained good cell counts (1800–2500 cells/mm2). Specular microscopy altered tissue grading in 38 eyes (60.31%), with 32 (84.21%) upgraded and 6 (15.79%) downgraded (p < 0.05). Tissues enucleated and preserved within 6 hours of death maintained higher CD values, while both phakic and pseudophakic eyes showed similar grading improvements. Overall, specular evaluation revealed that a significant number of donor corneas initially graded as suboptimal were suitable for transplantation after endothelial assessment. Conclusion: In our study, it was found that the Eye Rank Specular Microscopy can Significant alter the final grading of tissues and cause a vital different in its subsequent utilization for various transplant surgeries. In reality there exists a sizable pool of the good quality tissues amongst the available tissues which with improved evaluation techniques can add to the supply of available corneas. Thus for an eye bank, the eye bank specular microscope by providing variable quantitative and qualitative data becomes an indispensable tool for optimizing the availability of tissues for surgery and should be made mandatory analysis in all banks.