EEBA Program (PDF/3MB) - EEBA - Annual Meeting

PROSPECTIVE CLINICAL EVALUATION OF HYPOTHERMIC VS ORGAN CULTURED CORNEALGRAFTSM. Pauk Gulić, S. Lukačević, N. Miličić, N. Drača, M. Ratković, I. DekarisSpecial Eye Hospital Svjetlost, Department of Ophthalmology, School of Medicine in Rijeka, University of Rijeka, CroatiaPurpose: To compare clinical outcome of corneal transplantation patients using corneas preserved byhypothermic (group 1) or organ culture storage (group 2).Methods: Prospective study included 180 patients who underwent perforating keratoplasty in EyeClinic Svjetlost between March 2009 and April 2012. Patients were divided into two groups accordingto the donor corneal storage. Donor charts were reviewed for: death to preservation time (DP),condition of the epithelium in storage and preservation to surgery time (PS). Follow-up was 6-36months and included graft transparency, best corrected visual acuity, endothelial cell loss and othercomplications. The outcomes in two groups were compared.Results: In 75% transplanted patients donor corneas were perserved in hypotermic storage and 25%patients had their corneas stored in organ culture. Preoperative status of donor tissue from group1 was: epithelial exposure in 28% of corneas, epithelial defect in 4%, epithelial sloughing in 24%,intact epithelium in 45% and DP time was 9,5 (±6) hours. In group 2 there was no epithelial defectsand average DP time was 17 (±6.8) hours. Early epithelial defect (EED) occured in 14,8 % of patientsin group 1 immediately after PK, and none in group 2. EED have transfered to persistent epithelialdefect in 23% of patients. In group 2, visual acuity was better at month 1, but after 6 up to 36 monthsthere was no significant difference. Graft reaction occured in 10,7% of patient in group 1 and 5,7 % ingroup 2. Overall corneal graft survival rate in patients in group 1 was 91,6%, in group 2 97,2% and inpatients with PED 62,5%. Other complications such as postoperative astigmatism, intraocular pressureelevation and cataract formation did not differ at any time between the two investigated groups.Conclusions: Organ cultured donor corneas have lower rate of epithelial problems in a recipient eyes.Final graft outcome, ECD loss and visal outcome are not significantly different between patients withor without EED but in case of PED graft rejection becomes higher.50