Evaluation of the donor tissue during storage

Development of new surgical techniques for corneal transplantation induces major modifications in the graft selection process in eye banks. Quality of the donor corneal tissue must currently be assessed according to the scheduled surgical procedure. Not only the endothelial layer should be assessed by conventional techniques (trypan blue staining, light microscopy, specular microscopy) but also the corneal stroma and epithelium. This latter task requires development of new techniques such as high definition optical coherence tomography. Full field-OCT, in providing a detailed study of corneal structures with ultrahigh resolution (1 µm in all directions), permits detecting corneal conditions that are currently difficult to identify in eye banks, such as keratoconus, absence of Bowman’s layer, or corneal scars. It permits evaluating precisely Descemet’s membrane condition. It seems to be a promising technique in complement to current assessment methods of human donor corneas. Proper evaluation of the donor tissue by the new technologies implies formation of the eye bank staff. The staff has to get close relationships with the surgeons and to be attentive to the special requirements related to the scheduled surgical technique.