Purpose: To study the validity of endothelial polymegethism, pleomorphism, and “poor swelling” as tissue discard parameters in the immediate postmortem evaluation of human donor corneal endothelium.
Methods: We retrospectively evaluated the quality of the endothelium at first and second evaluations for all processed corneas exhibiting moderate polymegethism, pleomorphism, or “poor swelling” in our eye bank over a 5-year period.
Results: Out of 2008 eyes qualifying for our study, 422 corneas (21%) showed polymegethism, pleomorphism, or poor swelling at the first tissue evaluation immediately after excision of the corneoscleral button. In 363 (86%) of these corneas, a normal endothelial mosaic was observed at the second tissue evaluation after 7 to 21 days of organ culture, whereas only 59 (14%) still showed persistent polymegethism, pleomorphism, or “poor swelling” at that time point.
Conclusions: A recovery of normal endothelial cell mosaic and “normal swelling” at the second evaluation suggests that cellular contour parameters do not relate to tissue viability, but rather to a cellular stress reaction. If so, the validity of endothelial cellular contour morphology as an early parameter in assessing the suitability of a donor cornea for transplantation may be reconsidered.
*Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands
†Amnitrans EyeBank Rotterdam, Rotterdam, The Netherlands
‡Melles Cornea Clinic Rotterdam, Rotterdam, The Netherlands.
Reprints: Gerrit R. J. Melles, Netherlands Institute for Innovative Ocular Surgery, Laan op Zuid 88, 3071 AA Rotterdam, The Netherlands (e-mail: firstname.lastname@example.org).
The authors have no funding or conflicts of interest to disclose.
Dr Melles is a consultant for Dutch Ophthalmic Research Center International/Dutch Ophthalmic USA.
Received December 22, 2011
Accepted March 1, 2012