|Year : 1983 | Volume
| Issue : 5 | Page : 671-673
Honey dextran medium in preservation of cornea
M. & J. Institute of Ophthalmology, New Civil Hospital, Ahmedabad, India
M. & J. Institute of Ophthalmology, New Civil Hospital, Ahmedabad
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Lavingia B. Honey dextran medium in preservation of cornea. Indian J Ophthalmol 1983;31:671-3
The restrictions imposed by short-death to enucleation-time and early death of endothelialcells with moist chamber stored-corneas has promoted need for means to prolong corneal endothelial viability-postmortum.
Glycerine-A., Paraffin and Serum-St  etc. have been used for this purpose in past, M.K. medium has demonstrated superiority over all these media.
Honey-Dextran medium has been tried as a preservative since long. Moreover, rate of infection is very less, as it remains sterile by itself i.e. without adding any antibiotic.
This study is conducted to know the usability of Honey-Dextran medium as a preservative for cornea and its effect at different grades of temperature on the cornea.
Viability of the cells can be prolonged by supplying nutrition to the cells during the period of preservation. This can be done by adding 5% Dextran with honey and perfusing the eye-ball with Dextran alone or with mixture of Dextran 5% and Ringer's Solution in equal amounts.
| Materials and Methods|| |
39 human eyes were preserved for this study in medium containing 90% honey and 5% Doxtran in proportion of 3:1. Control groups of eyes were kept without any medium.
In the earlier part of study, corneas remaining after lamellar keratoplasty were studied for endothelial viability. Later on after seeing encouraging results, full-thickness corneo-scleral buttons were preserved and used for penetrating keratoplasty.
All the corneas used in this study were from donors between the age of 10 & 40 years and removed within 4 hours after death & kept at + 4°C till they were preserved.
Corneo-scleral buttons were kept in (H.D.) medium and preserved at different grades of temperature. Four groups were made and kept at -76°C, -20°C, 44°C and +37°C. Control eyes were preserved at the same ranges of temperature but without any preservative medium.
All these buttons were daily examined under microscope (40 x magnification) after 0.25% Trypanblue stainiog for 1˝ minute.  Viable-cells did not take stain, while nucleus of non-viable cells stained blue. Cell count was made, number of stained-nuclei were counted and photographed.
| Observations|| |
Graph-I:• Shows duration of viability of endothelium when corneo-scleral buttons were preserved in (H.D.) medium at different temperatures (on left side.) While right side shows, control eyes preserved without any medium in the similar way.
Endothelium remained viable for 6 days and usable for penetrating keratoplasty for 5 days in cornea preserved at-76° c in (H.D.) medium. In all other groups, viability remained for 3 days and the other cornea was usable for about 1 day (70% of the cells remained viable).
Corneas preserved without any medium when exposed to very high ranges of low temperature (-76° C & -20° C) cell death was immediate due to crystallization of intra-cellular fluids.
Corneas preserved at-76° C in (H.D.) medium were perfused for 20 minutes before preservation. Perfusion was done in with:
(1) 5% Dextran or with,
(2) 5% Dextran and Ringer's solution in equal amount.
(3) Third group was preserved without doing perfusion.
Graph-II: Shows comparative assessment of endothelial viability in these three groups. Perfusion with 5% Dextran for 20 minutes before preservation, keeps more number of endothelial-cells viable for 5 to 6 days. These corneas when used for penetrating-keratoplasty on 5t'' day, graft remained clear postoperatively.
| Summary|| |
Young, healthy corneas enucleated within 6 hours after death, can be preserved in 90% Honey + - 5% (3 : 1) at -76° C temperature after perfusion with 5% Dextran for 20 minutes to prolong endothelial viability for 5 to 6 days.
It is observed that Honey takes about 1 hour to solidify, when kept at -76° C. This brings about gradual reduction in the temperature, thus preventing crystallisation of intra-cellular fluids.
| References|| |
Bresin, C., Kaufman, Dextran Flux, Investigative Ophthalmology Vis. Sci., 16,
Castroveijo, Keratoplasty, Source and Preservation of Cornea, Ann. J. of Oph., 24, 139, 1941.
Hard Castle, R., Newmern, Corneal endothelium in Cryo Preservation of Tissue Visc. Sci., 16,
King, J.H., Glycerine Preservation of Cornea, Current methods, Springfield III, 1973.
Stocker, Clinical test of endothelium of donor Cornea, Arch. of Oph., 84,
Von Horn, D.L., Evaluation of Trypan blue staining for corneal endothelium, Springfield III, 1973.
[Figure - 1], [Figure - 2]