Corneal graft survival after prolonged storage in Optisol-GS.

PURPOSE: To evaluate the outcome of corneal transplants performed with donor corneas that had been stored for prolonged (>168 hours) periods of time in Optisol-GS storage media.

METHODS

A retrospective review was performed of the medical records of every patient who underwent corneal transplantation between January 1, 1999 and December 31, 1999 utilizing donor tissue that had been in Optisol-GS storage medium for more than 168 hours.

RESULTS

Two hundred thirty-four corneal transplants met the inclusion criteria. The mean duration of follow-up was 33.7 +/- 14.7 months (range 2 to 56 months). The mean Optisol-GS storage time was 237.1 +/- 41.6 hours (range 168 to 348 hours). The overall graft survival rate was 78.6%, ranging from a high of 100% for keratoconus to a low of 42.9% for therapeutic grafts. The likelihood of graft survival, of achieving a visual outcome of 20/40 or better, or of suffering a visual outcome of 20/200 or worse, was not statistically significantly affected by progressively longer periods of donor storage time for the entire study population or for any recipient diagnosis. There were no cases of primary graft failure or early (<3 months) microbial keratitis. An epithelial defect was present on the first postoperative day in every eye. Increased donor storage time was associated with a statistically significant increased risk of persistence of the postoperative epithelial defect for more than 7 days (P = 0.01) as well as for more than 14 days (P = 0.008), although the presence of a postoperative persistent epithelial defect did not have a statistically significant adverse impact on graft survival or visual outcome.

CONCLUSION

Satisfactory surgical outcomes can be achieved utilizing donor corneas that have been stored in Optisol-GS media for more than 7 days. Ophthalmologists utilizing such tissue should be cognizant of the inevitability of postoperative epithelial defects in these cases as well as increased likelihood of development of persistent epithelial defects.