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Effect of postmortem interval on the Graft Endothelium During Preservation and After Transplantation for Keratoconus

Parekh, Mohit MSc*; Salvalaio, Gianni BSc*; Ferrari, Stefano PhD*; Frigo, Anna C. MSc; Griffoni, Carlo MSc*; Grassetto, Andrea MSc*; Ruzza, Alessandro MSc*; Camposampiero, Davide BSc*; Ponzin, Diego MD*

doi: 10.1097/ICO.0b013e318283c873
Basic Investigation

Purpose: To investigate the effect of postmortem intervals and prognostic factors on endothelial cell density (ECD) of human donor corneas during preservation and at 1 and 3 years after transplantation in patients transplanted for keratoconus.

Methods: Two different studies were performed: (1) with 733 donor corneas selected for the preservation study and (2) 64 patients with keratoconus selected retrospectively from 2 hospital clinics. The corneas were evaluated on the basis of the ECD during preservation, study A, and at 1 and 3 years after transplantation, study B. The effect of ≥10 hours of postmortem interval on the percentage of corneal endothelial cell loss (ECL) was determined.

Results: The multiple regression showed no statistical significance (P = 0.827) of postmortem interval on ECL during preservation. However, for patients with keratoconus, the postmortem interval was statistically significant at both 1 year (P < 0.0001) and 3 years after transplantation (P < 0.0001).

Conclusions: The postmortem interval has no influence on the ECD during preservation. However, it has a statistically significant effect on the ECL after transplantation for patients transplanted for keratoconus, and therefore, it becomes eligible to be one of the potential factors affecting the ECD apart from surgical trauma.

*The Veneto Eye Bank Foundation, Venice, Italy; and

Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.

Reprints: Mohit Parekh, The Veneto Eye Bank Foundation, Padiglione Rama, Via Paccagnella, 11, 30174 Zelarino, Venice, Italy (e-mail:

The authors have no funding or conflicts of interest to disclose.

M. Parekh and G. Salvalaio contributed equally to this work.

Received August 15, 2012

Accepted December 17, 2012

© 2013 by Lippincott Williams & Wilkins.