Donor Endothelial Specular Image Quality in Optisol GS and Life4˚C

Authors

Chau Pham, Erik Hellier, CEBT, MBA, Minh Vo, MD, Loretta Szczotka-Flynn, OD, PhD, Beth Ann Benetz, MA, Jonathan Lass, MD

Keywords

corneal preservation medium, endothelium, specular microscopy

Abstract

PURPOSE: Identify warming time needed to obtain analyzable specular endothelial images in Optisol GS- and Life4˚C-stored corneas and identify other factors that contribute to endothelial image quality.

METHODS: Twenty-five transplant quality human corneal donor pairs were obtained. One cornea was placed in Optisol GS, the other in Life4˚C, in their respective viewing chambers, and both were stored at 2°C to 8°C for 48 hours. Specular microscopic images of the central endothelium were then obtained immediately following placement at room temperature, and additional images were taken every 30 minutes for a total of 3 hours. Image quality was graded by a single masked reader using a 6-point scale; an analyzable image was defined as grade >3.

RESULTS: Internal chamber temperature reached room temperature at 1.5 hours for both groups. The Optisol GS group had a higher average image grade than the Life4°C group at all time points; however, this difference was only significant at 1.5 hours and 2 hours: 2.8 ± 1.6 (SD) for Optisol GS versus 2.1± 1.1 for Life4°C at 1.5 hours (P=0.007), and 3.5 ± 1.5 versus 2.8 ±1.1 at 2 hours (P=0.007). Average image grade became analyzable at 2 hours for Optisol GS (3.5 ± 1.5) and at 2.5 hours for Life4°C (3.2 ± 1.1). Donor age and death–to-preservation time were not found to affect image quality.

CONCLUSIONS: Optisol GS-stored corneas should be warmed at room temperature for at least 2 hours, while Life4°C at least 2.5 hours, to achieve a good-to-excellent quality specular image of the donor endothelium.

doi:10.7706/ijeb.v1i2.52

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