Evaluation of Endothelial Viability in Human Donor Corneas

• The endothelial viability of 45 paired, isolated human corneas that were removed 7, 17, and 41 hours after death was determined using in vitro perfusion with a modified HEPES (N'-2-hydroxyethylpiperazine-N'-ethanesulfonic acid)-buffered, glutathione-bicarbonate Ringer's solution. During the test period of four hours, a significant decrease in corneal thickness, measured by specular microscopy, occurred within the first two hours. The improved endothelial visualization allowed simultaneous cell-density measurements. Perfused corneas showed an almost intact endothelial ultrastructure compared with their 45 partners that were examined immediately after removal. Control corneas were perfused with isotonic saline. They failed to reverse their postmortem swelling and continued to increase in thickness at a rate of 45 ± 54 μm/hr.