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. 2022 Dec 1;41(12):1539-1544.
doi: 10.1097/ICO.0000000000003108. Epub 2022 Sep 9.

Comparison of Graft Outcomes Reusing Original Intermediate-Term Cold Storage Solution for Entire Corneal Donor Storage Period With Exchanged Fresh Storage Solution After Donor Preparation in the Cornea Preservation Time Study

Jonathan H Lass  1   2   3 , Ryan J Bailey  4 , Loretta B Szczotka-Flynn  1 , Beth Ann Benetz  1   2 , Mark Soper  5 , Michael S Titus  3 , Craig Kollman  4 , Roy W Beck  4 ; Cornea Preservation Time Study Group
Affiliations

Comparison of Graft Outcomes Reusing Original Intermediate-Term Cold Storage Solution for Entire Corneal Donor Storage Period With Exchanged Fresh Storage Solution After Donor Preparation in the Cornea Preservation Time Study

Jonathan H Lass et al. Cornea. .

Abstract

Purpose: The purpose of this study was to evaluate outcomes of Descemet stripping automated endothelial keratoplasty comparing exchange with fresh intermediate-term cold storage solution after lenticule preparation versus reuse of the original solution in the Cornea Preservation Time Study.

Methods: In the Cornea Preservation Time Study, 508 donor corneas had lenticules prepared by the eye bank with fresh solution exchange (Fresh group) and 283 with reuse of the original solution (Original group). Storage time for all donors was ≤11 days. Graft success rates, central endothelial cell loss at 3 years, and frequency of positive donor rim cultures were compared between the 2 groups.

Results: The 3-year graft success rate (95% confidence interval) was 93.4% (90.7%-95.3%) in the Fresh group and 95.2% (91.8%-97.2%) in the Original group (adjusted hazard ratio for graft failure = 0.64, 95% confidence interval, 0.33-1.24, P = 0.19). The mean percentage endothelial cell loss was significantly greater in the Fresh group versus Original group (45% ± 22% vs. 38% ± 20%, respectively, P = 0.004). Cultures were positive in 4 (1.5%) of 267 donor rims (3 fungal and 1 bacterial) in the Fresh group and in 4 (2.5%) of 158 in the Original group ( P = 0.57). There were 2 postoperative infections in the Original group and none in the Fresh group.

Conclusions: The use of the original intermediate-term cold storage solution did not reduce the 3-year graft success rate compared with exchanging with fresh solution after lenticule preparation for Descemet stripping automated endothelial keratoplasty, while the frequency of positive donor rim cultures did not significantly differ between groups.

Trial registration: ClinicalTrials.gov NCT01537393.

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Conflict of interest statement

The following authors have financial disclosures with companies that manufacture corneal storage solutions (considered relevant to this work): M. Terry (Bausch & Lomb) and W. B. Lee (Bausch & Lomb) (part of CPTS Study Group but not authors on this paper). These authors are employed by eye banks: M. Soper (VisionFirst), and M. S. Titus (Eversight). J. H. Lass is a voluntary board member of Eversight and the Cleveland Eye Bank Foundation. The remaining authors have no conflicts of interest to disclose.

Figures

FIGURE 1.
FIGURE 1.
Kaplan-Meier estimates of graft success during the 3-years post-surgery by storage solution procedure type (Fresh [n = 508] and Original [n = 283]). The probability of graft success at 3 years post-surgery was 93.4% (90.7%, 95.3%) in the Fresh group and 95.2% (91.8%, 97.2%) in the Original group. The inset shows the same data on a truncated vertical axis.
See this image and copyright information in PMC

Comment in

References

    1. Lass JH, Szczotka-Flynn LB, Ayala AR, et al. ; Writing Committee for the Cornea Preservation Time Study Group. Cornea Preservation Time Study: methods and potential impact on the cornea donor pool in the United States. Cornea. 2015;34:601–608. - PMC - PubMed
    1. Rosenwasser GO, Szczotka-Flynn LB, Ayala AR, et al. ; Cornea Preservation Time Study Group. Effect of cornea preservation time on success of Descemet stripping automated endothelial keratoplasty: a randomized clinical trial. JAMA Ophthalmol. 2017;135:1401–1409. - PMC - PubMed
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