AGE BASED SPECULAR MICROSCOPIC EVALUATION OF FIRST 50 CORNEAL TISSUE OBTAINED THROUGH HCRP AT A NEWLY ESTABLISHED EYE BANK IN EASTERN INDIA

Abstract

Background – Cornea transplantation has an important role in reducing the burden of corneal blindness but availability of corneal donor tissue is a significant limitation. The overall utilization of available cornea is further limited by the quality of donor corneal tissue.Specular microscopic evaluation of donor cornea is emerging as an indispensable tool of endothelial evaluation. Aim – Aim of this study to do an age based specular microscopic evaluation of first 50 corneal tissue obtained through hospital cornea retrieval program at a newly established eye bank in Eastern India Material and method – Total 50 corneo-scleral donor tissue were included in study after excluding the contraindication of cornea donation. Three tissues were could be not included in final assessment due to unavailability of specular microscopic image.47 tissues were divided in different age groups – <20 years (10 tissues),20-40 years (10 tissues),40-60 years (10 tissue) an >60 years (17 tissues). Specular microscopic evaluation was done with Konan eye bank keratoanlyser - CellChek® D® (Konan Medical, Irvine, CA). Endothelial cell density (ECD), corneal thickness (CT), coefficient of variance (CV) and percentage of hexagonal cells (6A) were evaluated and correlated with age. Result – The average age of donor was 47.02 years. The average CT, ECD, CV and 6A were 523.42 +/- 16.37 micron, 2222.87 +/- 514.62 cells/mm2, 35.27 +/- 4.04, 53.06 +/-8.30 % respectively.The difference in ECD was significantly high in age group <20 years than in comparison to those between 20-40 years (p value - 0.018),40-60 years (p value - 0.003) and more than 60 years (p value - 0.0001). There was a progressive decrease in ECD count with age but the change in ECD count between age group 20-40years and 40-60 years was not significant (p value - 0.12).ECD was significantly low in age group > 60 years in comparison to all other group i.e.<20 years (p value – 0.0001), 20-40 years (p value - 0.003) and 40-60 years (p value - 0.016). There was no significant difference in any other parameter (CT, CV, 6A) in any of the age group. Conclusion - Eye bank specular microscope is an important tool in proper evaluation of donor corneo-scleral button. The ECD is significantly high in tissue from younger age of donor with a progressive decrease in age.CCT,CV and 6A are found to have no correlation with age.