RT Journal Article
SR Electronic
T1 Cornea procurement from very old donors: post organ culture cornea outcome and recipient graft outcome
JF British Journal of Ophthalmology
JO Br J Ophthalmol
FD BMJ Publishing Group Ltd.
SP 404
OP 411
DO 10.1136/bjo.86.4.404
VO 86
IS 4
A1 P Gain
A1 G Thuret
A1 C Chiquet
A1 P Rizzi
A1 J L Pugniet
A1 S Acquart
A1 J J Colpart
A1 J C Le Petit
A1 J Maugery
YR 2002
UL http://bjo.bmj.com/content/86/4/404.abstract
AB Aim: To study the suitability of corneas from very old donors for graft after banking and their clinical and endothelial outcomes in recipients. Methods: 419 corneas stored in organ culture were divided into group 1, donors under 85 years (330 corneas) and group 2, “very old” donors aged 85 years and over (89 corneas). Endothelial cell density (ECD) before and after organ culture, discard rate before and after storage, and clinical and endothelial outcomes of the 196 penetrating keratoplasties (PKP) (158 in group 1 and 38 in group 2) were compared in a prospective longitudinal study. Results: Initial ECD was lower in group 2 than in group 1 and elimination for low ECD was more frequent in group 2 (respectively 38% v 20.2%, p=0.001). At the end of storage, because very old corneas lost fewer ECs than younger ones (respectively 4.2% v 9.5%, p=0.022), ECD was comparable between the two groups. The corneas of very old donors had a poorer macroscopic appearance at procurement and during surgery. Despite this, in grafted patients, overall graft survival in groups 1 and 2 (respectively 87.4% v 80.6%, p=0.197), visual acuity, and ECD did not differ at completion of the study (mean follow up 25 months). Conclusion: This study suggests that endothelial cell count during banking ensures that functional and cellular results of PKPs are not dramatically influenced by very old donor age. Considering Europe's ageing population, the very elderly should not be deemed off limits for corneal procurement.