Comparison of rabbit and human corneas stored in Optisol-GS: changes in stromal sodium

Enhancing Rose Bengal penetration in ex vivo human corneas using iontophoresis

Aim: Rose Bengal photodynamic antimicrobial therapy (RB-PDAT) has poor corneal penetration, limiting its efficacy against acanthamoeba keratitis (AK). Iontophoresis enhances corneal permeation of charged molecules, piquing interest in its effects on RB in ex vivo human corneas. Methods: Five donor whole globes each underwent iontophoresis with RB, soaking in RB, or were soaked in normal saline (controls). RB penetration and corneal thickness was assessed using confocal microscopy. Results: Iontophoresis increased RB penetration compared with soaking (177 ± 9.5 μm vs. 100 ± 5.7 μm, p < 0.001), with no significant differences in corneal thickness between groups (460 ± 87 μm vs. 407 ± 69 μm, p = 0.432). Conclusion: Iontophoresis significantly improves RB penetration and its use in PDAT could offer a novel therapy for acanthamoeba keratitis. Further studies are needed to validate clinical efficacy.

Effect of glucose on the stress-strain behavior of ex-vivo rabbit cornea

The biomechanical changes in rabbit cornea preserved in storage media with different glucose concentrations are experimentally assessed. Two groups of eight fresh rabbit corneas were preserved for 10 days in storage medium Optisol-GS with glucose concentrations of 14 and 28 mM, respectively. Eight additional corneas preserved, glucose-free, in the same medium served as the control group. All specimens were tested under inflation conditions up to 45 mmHg posterior pressure, and the pressure-deformation data obtained experimentally were analyzed using shell theory to derive the stress-strain behavior. Comparisons were held between the three specimen groups in order to determine the effect of glucose concentration on corneal biomechanical behavior and thickness. After storage, the mean central corneal thickness in the control, low-glucose and high-glucose groups underwent statistically significant increases of 38.7 ± 11.3%, 45.4 ± 7.6% and 50.6 ± 8.6%, respectively. The corneas also demonstrated consistent stiffness increases with higher glucose concentrations. The tangent modulus values determined at different pressure levels between 10 and 40 mmHg underwent statistically significant increases with glucose level (P < 0.05). Compared to the control group, other specimens had higher tangent modulus by 17-20% on average with low glucose and 30-37% with high-glucose concentration. The results of the study indicate that the influence of the high-glucose level commonly experienced in diabetes on the biomechanical stiffness of the cornea should be considered in clinical management and in understanding corneal ectasia, glaucoma and the response to refractive surgery.

The effects of epithelial viability on stromal keratocyte apoptosis in porcine corneas stored in Optisol-GS

PURPOSE

To investigate the effect of corneal epithelium on the viability of corneal stromal keratocytes in Optisol-GS.

METHODS

After sterilization, corneoscleral buttons were excised and stored in Optisol-GS for various time periods. Group 1 corneas (n = 40) underwent mechanical corneal epithelial debridement before storage while group 2 corneas (n = 40) were stored with intact epithelium. Changes in corneal thickness, keratocyte density, and keratocyte apoptosis were investigated immediately, at 4 hours, and on days 1, 2, 3, 5, 7, and 14 in the preservation medium. The differences between group 1 and 2 corneas were analyzed.

RESULTS

Corneal thickness increased significantly in the second week of preservation in both groups, though more substantially in group 1. Significant corneal epithelial apoptosis was noticed in the first week in group 2 corneas. Corneal stromal keratocyte density decreased with prolonged preservation time. DNA laddering was detected by ligation-mediated polymerase chain reaction throughout the experiment periods in both groups, but the increase of keratocyte apoptosis was more significant after 5 days of preservation, especially in group 1.

CONCLUSIONS

Stromal keratocytes underwent apoptosis in Optisol-GS. The absence of corneal epithelium during preservation further increased the stromal keratocyte apoptosis.