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Corneal Storage, Hypothermia, and Organ Culture

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Light and Specular Microscopy of the Cornea

Abstract

This chapter provides information about hypothermia and organ culture, the two basic approaches to storing corneas for grafting. Procedural simplicity and the immediate availability of tissue for transplantation make hypothermia the most widely used method. The recommended maximum storage time under hypothermic conditions (2–8 °C) is 14 days. Corneas placed in either vials or viewing chambers containing a commercially available storage solution and protected by a tamper-proof seal may be evaluated by slit lamp and specular microscopy prior to grafting. The main goal of hypothermic storage is to use low temperatures to suppress metabolic activity, inhibit cellular processes, and reduce energy demand in the tissue and thus maintain the original condition of the cornea. Macromolecules, such as dextran or chondroitin sulfate, are present in the medium control stromal hydration and prevent swelling of the cornea. Organ culture storage is used in about 65 % of European eye banks because of the possibility of performing a detailed assessment of the corneal endothelium and extending storage time up to 4–5 weeks. The corneas are generally maintained at 30–37 °C in media based on a minimal essential medium supplemented with fetal bovine serum, thus allowing the cornea to metabolize, that is, the endothelium can be repaired and the morphometric parameters improved. Similarly, the epithelium can be renewed from the limbus. Organ culture permits the detailed control of corneal quality, including the assessment of dead endothelial cells using light microscopy. However, during organ culture, the stroma typically becomes edematous, and the cornea increases in thickness. Shortly before the planned transplant, the cornea is therefore transferred to a medium containing macromolecular substances in which tissue dehydration and thinning occur. Microbiologic testing of the culture media ensures that microorganisms can be detected throughout the entire storage procedure. It appears that both storage methods result in similar graft survival.

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Authors and Affiliations

  1. Laboratory of the Biology and Pathology of the Eye, Institute of Biology and Medical Genetics, First Faculty of Medicine, Charles University, Prague, Czech Republic

    Katerina Jirsova

  2. The Eye-Bank for Sight Restoration, Inc., 120 Wall Street, New York, NY, 10005, USA

    Patricia Dahl

  3. Bristol Eye Bank, NHS Blood and Transplant, and School of Clinical Sciences, University of Bristol, Bristol Eye Hospital, Lower Maudlin Street, Bristol, BS1 2LX, UK

    W. John Armitage

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  1. Katerina Jirsova
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  2. Patricia Dahl
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Correspondence to Katerina Jirsova .

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Jirsova, K., Dahl, P., Armitage, W.J. (2017). Corneal Storage, Hypothermia, and Organ Culture. In: Light and Specular Microscopy of the Cornea. Springer, Cham. https://doi.org/10.1007/978-3-319-48845-5_3

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