A standardized methodology for longitudinal assessment of corneal endothelial morphometry in eye banked corneas

Authors

  • Zala Lužnik Schepens Eye Research Institute, Department of ophtalmology, Harvard medical school, Boston
  • Zhongmou Sun Schepens Eye Research Institute, Department of ophtalmology, Harvard medical school, Boston
  • Jia Yin Schepens Eye Research Institute, Department of ophtalmology, Harvard medical school, Boston
  • Beth Ann Benetz Cornea Image Analysis Reading Center, Department of Ophthalmology and Visual Sciences, Case Western Reserve University and University Hospitals Eye Institute, Cleveland, OH.
  • Jonathan H. Lass Cornea Image Analysis Reading Center, Department of Ophthalmology and Visual Sciences, Case Western Reserve University and University Hospitals Eye Institute, Cleveland, OH.
  • Reza Dana Schepens Eye Research Institute, Department of ophtalmology, Harvard medical school, Boston

DOI:

https://doi.org/10.14440/jbm.2019.304

Keywords:

human donor cornea, corneal endothelium, wide-field dual imaging specular microscopy, eye banking

Abstract

Eye banked research-grade human donor corneas serve as principal ex vivo source for studying the mechanisms that underlie corneal endothelial cell damage/death and survival. Wide-field specular microscopy can be used for corneal endothelial visualization and allows for indirect assessment of endothelial cell function by analyzing endothelial cell density and morphometric parameters. However, a standardized approach is needed to observe corneal endothelial changes over time. This protocol describes reliable ex vivo methods for consecutive analyses of human donor corneal endothelial cell density and morphometric parameters change using a wide-field dual imaging specular microscope. This protocol involves tissue warming, acquisition and analysis of specular endothelial images, assessment of corneal layers with the new Enhance mode, optical pachymetry measurement, and qualitative image quality grading scales. This quantitative and qualitative evaluation of donor corneas allows for a systematic analysis of endothelial dynamic responses to ex vivo induced stress and can be used as a valuable tool to better elucidate specular findings and mechanisms mediating corneal endothelial cell loss in corneal disease and after transplantation.

Author Biography

Zala Lužnik, Schepens Eye Research Institute, Department of ophtalmology, Harvard medical school, Boston

Postodoctoral research fellow

MD, PhD

References

Corcoran KP 2018 Accessibility to and quality of human eye tissue for research: A cross-sectional survey of ARVO members. Investig Ophthalmol Vis Sci 59:4783-4792.

Heinzelmann S, Böhringer D, Eberwein P, Reinhard T, Maier P (2016) Outcomes of Descemet membrane endothelial keratoplasty, Descemet stripping automated endothelial keratoplasty and penetrating keratoplasty from a single centre study. Graefes Arch Clin Exp Ophthalmol 254:515-22.

Matsuda M, Glasser DB, Geroski DH, Edelhauser HF (1986) Specular Microscopic Evaluation of Donor Corneal Endothelium. Arch Ophthalmol 104:259-262.

McCarey BE, McNeill JI (1977) Specular Microscopic Evaluation of Donor Corneal Endothelium. Ann Ophthalmol 9:1279-83.

Benetz BA, Lass JH (2018) Specular Microscopy. Cornea 37 Suppl 1:S7-S8.

Konan Medical. CellChek D donor corneal analysis. Available from: https:// konanmedical.com/cellchek-d/.

Gray KE (2018) Wide-Field Ex Vivo Dual Imaging Microscopy. Cornea 37 Suppl 1:S11-S13.

Tran KD, Clover J, Odell K, Stoeger CG (2016) Comparison of Endothelial Cell Measurements by Two Eye Bank Specular Microscopes. Int J Eye Bank 4:1-8.

Lass JH, Gal RL, Ruedy KJ, Benetz BA, Beck RW, et al. (2005) An evaluation of image quality and accuracy of eye bank measurement of donor cornea endothelial cell density in the Specular Microscopy Ancillary Study. Ophthalmology 112:431-440.

Benetz BA, Gal RL, Ruedy KJ, Rice C, Beck RW, et al. (2006) Specular microscopy ancillary study methods for donor endothelial cell density determination of Cornea Donor Study images. Curr Eye Res. 31:319-327.

Benetz BA, Stoeger CG, Patel S V., OʼBrien RC, Szczotka-Flynn LB, et al. (2019) Comparison of Donor Cornea Endothelial Cell Density Determined by Eye Banks and by a Central Reading Center in the Cornea Preservation Time Study. Cornea 38:426-432.

Pham C, Hellier E, Vo M, Szczotka-flynn L, Benetz BA, Lass JH (2013) Donor Endothelial Specular Image Quality in Optisol GS and Life4ËšC. IJEB 1:1-8.

Tran KD, Clover J, Ansin A, Stoeger CG, Terry MA (2017) Rapid Warming of Donor Corneas Is Safe and Improves Specular Image Quality. Cornea 36:581-587.

Sayegh RR, Benetz BA, Lass JH (2016) Specular Microscopy. In: Mark Mannis, Edward Holland, editors. Cornea, 2-Volume Set 4th Edition. Elsevier Inc. pp. 160-179.

McCarey BE, Edelhauser HF, Lynn MJ (2008) Review of Corneal Endothelial Specular Microscopy for FDA Clinical Trials of Refractive Procedures, Surgical Devices and New Intraocular Drugs and Solutions. Cornea 27:1-16.

Means TL, Geroski DH, Hadley A, Lynn MJ, Edelhauser HF (1995) Viability of human corneal endothelium following Optisol-GS storage. Arch Ophthalmol 113:805-809.

Lass JH, Benetz BA, Verdier DD, Szczotka-Flynn LB1, Ayala AR, et al. (2017) Corneal Endothelial Cell Loss 3 Years After Successful Descemet Stripping Automated Endothelial Keratoplasty in the Cornea Preservation Time Study. JAMA Ophthalmol 135:1394-1400.

Terry MA, Shamie N, Straiko MD, Friend DJ, Davis-boozer D (2011) Endothelial keratoplasty: the relationship between donor tissue storage time and donor endothelial survival. Ophthalmology 118:36-40.

Writing Committee for the Cornea Donor Study Research Group, Lass JH, Benetz BA, Gal RL, Kollman C, Raghinaru D, et al. (2013) Donor age and factors related to endothelial cell loss 10 years after penetrating keratoplasty: Specular microscopy ancillary study. Ophthalmology 120(12):2428-2435.

Pels E, Schuchard Y (1984-1985) The effects of high molecular weight dextran on the preservation of human corneas. Cornea 3:219-227.

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Published

2019-11-20

How to Cite

1.
Lužnik Z, Sun Z, Yin J, Benetz BA, Lass JH, Dana R. A standardized methodology for longitudinal assessment of corneal endothelial morphometry in eye banked corneas. J Biol Methods [Internet]. 2019Nov.20 [cited 2021Oct.21];6(4):e120. Available from: https://jbmethods.org/jbm/article/view/304

Issue

Section

Protocols

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