An in vitro and clinical comparison of corneal storage with chondroitin sulfate corneal storage medium with and without dextran.

Abstract

The safety and efficacy of 1% dextran in Chondroitin Sulfate Corneal Storage Medium (CSM) in reducing corneal swelling after 4 degrees C storage was assessed in a corneal endothelial cell culture system. No difference was found in 3H-thymidine incorporation by cells incubated in either CSM-dextran medium or CSM medium alone. Subsequently, 21 pairs of corneas, stored in either CSM or CSM-dextran from 30 to 112 hours, were transplanted into 42 eyes of 42 patients, paired by diagnostic group and procedure. All CSM grafts and 19 of 21 CSM-dextran grafts were clear at 4 months with no primary donor failures in either group. Intraoperative corneal thickness was significantly greater in the CSM group (0.82 +/- 0.07 mm) than the CSM-dextran group (0.76 +/- 0.06 mm); however, the two groups did not differ thereafter. No differences in all endothelial morphometric parameters were noted between the two groups pre- and postoperatively. Average endothelial cell loss by 4 months was 13.0 +/- 16.4% for the CSM group and 16.4 +/- 15.5% for the CSM-dextran group. The addition of dextran to CSM medium results in significant intraoperative corneal thinning without adversely affecting endothelial DNA synthesis in vitro and endothelial survival in vivo.