A randomized, prospective, double-masked clinical trial of Optisol vs DexSol corneal storage media
J. H. Lass, W. M. Bourne, D. C. Musch, A. Sugar, J. F. Gordon, W. J. Reinhart, R. F. Meyer, D. I. Patel, W. E. Bruner, D. B. Cano and al. et
Department of Ophthalmology, Case Western Reserve University, Ohio 44106.
We compared Optisol and DexSol, two chondroitin-sulfate-based media for
corneal storage at 4 degrees C, by transplanting 31 donor cornea pairs (one
cornea stored in Optisol and its mate in DexSol for 20 to 134 hours) into
31 pairs of recipients (62 patients). All grafts were clear 1 year after
transplantation except for one primary donor failure (Optisol group).
Optisol-stored corneas were significantly thinner than DexSol-stored
corneas after cardinal suture placement (0.64 mm vs 0.76 mm) and at the end
of surgery (0.69 mm vs 0.78 mm); at all points afterward through 1 year the
two groups did not differ. The activity of two lysosomal enzymes released
into the media during storage, alpha-mannosidase and alpha-glucosidase, was
lower in the Optisol group. Epithelial status and all endothelial
morphometric parameters, except the figure coefficient at 1 year, did not
differ between the two groups before surgery and 3, 6, and 12 months after
surgery. Mean endothelial cell loss at 1 year was 15% for the Optisol group
and 21% for the DexSol group (P = .22). Thus, Optisol-stored corneas were
thinner during surgery than DexSol-stored corneas and there was less
lysosomal enzyme activity in the Optisol medium after tissue storage. There
were no significant differences in postoperative clinical or endothelial
morphometric parameters, however.
