Factors affecting the epithelial integrity of human donor corneas

PURPOSE: To evaluate various factors affecting the integrity of human donor corneal epithelium. METHODS: Donor corneal buttons were evaluated for epithelial defect (ED) and exposure. The slit-lamp photographs were taken on day 01, and the data such as age and gender of the donor, cause of death, refrigeration of cadavers, death-to-preservation time (DPT), experience of technician, and distance from site of collection to eye bank were collected. RESULTS: A total of 100 consecutive corneal buttons belonging to 56 donors were evaluated. The median age of donors was 50 years. Males constituted 45 (80.4%). The mean DPT was 9.7 ± 5.3 hours. After death, 34 donors (60.7%) were refrigerated before the collection/retrieval. Most of the corneas (80%) were recovered by technicians having an experience of 0–5 years. Thirty-one donors (55.3%) were located at 1–50 km from the eye bank. The mean area of exposure was 15 ± 4.3 mm(2). The mean area of ED was 28.7 ± 5.9 mm(2). ED was significantly associated with refrigeration of cadavers and longer DPT. On multivariate analysis, only DPT was found to be significantly associated (P = 0.006; odds ratio [OR] = 1.54 ± 0.24) with the presence of ED. After transplantation, only two corneas had persistent epithelial defects and were treated successfully using various interventions. CONCLUSION: Integrity of donor corneal epithelium is mainly influenced by the refrigeration of cadavers and DPT.