Document Detail

Whole globe enucleation versus in situ excision for donor corneal retrieval--a prospective comparative study.
MedLine Citation:
PMID:  19034121     Owner:  NLM     Status:  MEDLINE    
PURPOSE: The purpose of this study was to compare the results after changing from conventional whole globe enucleation to in situ excision of donor corneas. METHODS: Donor corneal tissue retrieved by enucleation (n = 50) and in situ excision (n = 50) was quantitatively evaluated prospectively, and the main parameters evaluated were endothelial cell counts, ultrasonic corneal pachymetry, microbial contamination, graft clarity, and postoperative median visual acuity at the end of 3 months. RESULTS: Mean preoperative donor endothelial cell densities were 2174 +/- 123 and 2132 +/- 149 cells per millimeter square after enucleation and in situ excision, respectively (P = 0.13). The preoperative disease distribution and visual potential of recipients were comparable between the 2 groups. Corneal pachymetry was lower in the whole globe group at the end of 3 months (528 microm, enucleation group; and 539 microm, in situ group; P = 0.01). The mean postoperative endothelial cell counts were comparable in both groups at 3 months (1708 +/- 104.8/mm for whole globe group, measured in 40 eyes, vs 1674 +/- 117.4/mm in in situ group, recorded in 39 eyes; P = 0.18). The number of positive corneoscleral rim cultures postkeratoplasty was statistically comparable in both groups (20% in enucleation group and 24% in in situ group; P = 0.62). At 3 months, 98% and 92% of grafts had a graft clarity of >or=3+ in whole globe and in situ groups, respectively (P = 0.16). Seventy-two percent of patients in whole globe group and 67% in in situ group achieved a best-corrected visual acuity of >or=0.1. Postoperative graft infection developed in 2 cases in the in situ group. CONCLUSIONS: Changeover from whole globe enucleation technique to in situ excision technique of harvesting donor corneas demonstrated that in situ excision is a viable alternative.
Vishal Jhanji; Radhika Tandon; Namrata Sharma; Jeewan S Titiyal; Gita Satpathy; Rasik B Vajpayee
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Cornea     Volume:  27     ISSN:  1536-4798     ISO Abbreviation:  Cornea     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-11-26     Completed Date:  2009-02-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8216186     Medline TA:  Cornea     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1103-8     Citation Subset:  IM    
Cornea and Refractive Surgery Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
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MeSH Terms
Bacteria / isolation & purification
Cell Count
Cornea / microbiology,  pathology,  surgery*
Corneal Transplantation / adverse effects
Corneal Ulcer / etiology
Endophthalmitis / etiology
Endothelium, Corneal / pathology
Eye Enucleation*
Fungi / isolation & purification
Infection / etiology
Middle Aged
Postoperative Period
Prospective Studies
Tissue Donors
Tissue and Organ Harvesting / methods*
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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