In situ corneal excision - Experience of the Lions Cornea Bank of Nordrhein-Westfalen in 1995 and 1996

Background: Donor corneas are normally obtained by whole globe enucleation - a procedure often refused by the bereaved. To increase the acceptance of cornea donation, we have exclusively obtained donor corneas by in situ excision since the end of 1994. There have been reports of increased endothelial damage and higher contamination rates. We report our experience in 1995 and 1996. Methods: The in situ excision was performed by staff trained in microsurgical techniques. Only donor corneas with negative end-storage cultures after at least 10 days and an endothelial cell count of more than 2500 cells/mm(2) were used for transplantation. Results: In all, 705 corneoscleral buttons were excised from 1/95 to 12/96. The bereaved consented in 34 % in 1996. A total of 30.5 % of the corneas were ineligible for transplantation which corresponds to the discard figures from all cornea banks with culture methods. We did not observe any primary transplant failure nor endophthalmitis after 444 perforating keratoplasties. Conclusion: In situ corneal excision is safe, and helps to reduce the shortage in donor corneas.