Setting up organ‐cultured corneas pre‐cutting by a French blood center‐eye bank

Abstract

AbstractPurpose In France, the cutting of endothelial graft for DSAEK is almost exclusively performed by surgeons directly in the operating room whereas in the US more than 2/3 are now precut by eye banks (EB) technicians using 4°C storage. Among the French Blood Center EB, the EB of St‐Etienne received the first agreement from the French National Agency for Medicines and Health products for precutting and distribution of corneas. Aim: to report our first experience with DSAEK precut by technicians using organ‐cultured (OC) corneasMethods OC corneas with an initial endothelial cell density (ECD) >2200 cells/mm2 (by image analysis) were precut by two trained technicians using a Moria microkeratome. Corneas were stored in CMax (Eurobio) and deswelled in CJet (5% Dextran T500) 20h prior to pre‐cutting. Central corneal thickness (CCT) was measure by ultrasound before and after cut with a single pass of the 350μm head. Microbiological testing was done with blood culture bottles 24h after precuttingResults Twelve corneas with initial ECD of 2724±269 cells/mm2 (mean±SD), 19±4 days of OC and CCT of 548±50 μm were cut and sent to 4 centers (Feb to May 2013). Final CCT was 194±33μm (166 to 277). All surgeries were uneventful but rebubbling was necessary in 6 cases and 1 graft with eccentric trephination by the surgeon did never adhereConclusion Precutting of OC corneas by EB allows quality and microbiology controls. Three improvements are ongoing: OCT thickness map before, during and after cut, use of the microkeratome double‐pass technique, and ink marking of the centre to guide final trephination by surgeons. Grants: ONDAINE, AOL CHU 2012