Microbiological contamination in donor corneas preserved for medium-term.

To evaluate the characteristics of microbiological contamination in donor corneas preserved for medium-term. A total of 82 donated corneas from June 1, 2014 to November 30, 2014 were retrospectively analyzed. The corneas were preserved in cornea chambers medium-term solution at 4-8 °C for keratoplasty. After removal of the central corneas for transplantation, the corneoscleral rims were put back into the medium for 1 month at room temperature (20-25 °C). The suspicious contaminated storage solutions indicated with transparency or color change were examined with bacteria and fungi cultivation for strain identification. The data collected included gender, age, procurement site and causes of death of donors, and follow-up of recipients. Statistical analysis was performed using Microsoft Excel and SPSS 24.0. Significance level was set at a P value < 0.05. The overall pathogen positive rate was 9.8% (n = 8), including 7 (87.5%) fungi and 1 (12.5%) bacteria. They were 2 (2.44%) Fusarium, 2 (2.44%) Chromomycosis, 1 (1.22%) Candida albicans, 1 (1.22%) Aspergillus versicolor, 1 (1.22%) Acremonium species, and 1 (1.22%) Enterococcus. 5 contaminated corneas were used for penetrating keratoplasty; although four out of five (80%) had not been given antifungal drugs during more than 6 months following-up period, none of the recipients was infected with a graft. Donor age (P = 0.839), gender (P = 0.062), procurement sites (P = 0.713) and cause of death (P = 0.711) had no statistically significant influence on the contamination rate. All donor corneas have a possibility of microbiological contamination. Strict tissue preservation protocol but not antifungal drugs following keratoplasty seems necessary to prevent graft infection.

Expression of efflux transporters in human ocular tissues.

To investigate the expression profiles of efflux transporters in human ocular tissues, quantitative real-time polymerase chain reaction, Western blotting, and immunohistochemistry were used to obtain the relative mRNA and protein expressions of various efflux transporters in human ocular tissues. The cornea, conjunctiva, iris-ciliary body (ICB), retina and choroid, human corneal epithelial cell line (HCEC), and human retinal pigment epithelial cell line (ARPE-19) were examined for the expressions of multidrug resistance-associated proteins 1-7 (MRP1-7), multidrug resistance 1 (MDR1) P-glycoprotein, lung resistance protein (LRP), and breast cancer-resistance protein (BCRP). The expression sites and patterns of efflux transporters were significantly different in ocular tissues, HCEC, and ARPE-19, as well as the expression profiles of efflux transporters in mRNA and protein levels in ocular tissues. At the protein level, MRP1-7, MDR1, and LRP were expressed in the corneal epithelium; MRP1-7, MDR1, LRP, and BCRP were expressed in the conjunctival epithelium; MRP1-2, MRP6-7, MDR1, and LRP were expressed in the ICB; MRP1-3, MRP6-7, MDR1, and LRP were expressed in the retina; MRP1-3, MRP6-7, MDR1, and LRP were expressed in the HCEC; and MRP7, MDR1, LRP, and BCRP were expressed in the ARPE-19. This quantitative and systematic study of efflux transporters in normal ocular tissues and cell lines provides evidence of cross-ocular tissue transporter expression differences, implying that efflux transporter expression variability should be taken into consideration for better understanding of ocular pharmacokinetic and pharmacodynamic data.

Mutation analysis of paired box 6 gene in inherited aniridia in northern China.

PURPOSE: Aniridia is phenotypically and genetically heterogeneous. This study is to summarize the phenotypes and identify the underlying genetic cause of the paired box 6 (PAX6) gene responsible for aniridia in two three-generation Chinese families in northern China. METHODS: A detailed family history and clinical data were collected from patients during an ophthalmologic examination. All exons and flanking intronic sequences of the PAX6 gene were amplified with PCR and screened for mutation with direct DNA sequencing. Haplotyping was used to confirm the mutation sequence. Real-time PCR was used to determine the PAX6 messenger ribonucleic acid(mRNA) level in patients with aniridia and in unaffected family members. RESULTS: The probands and other patients in the two families were affected with aniridia accompanied with or without congenital cataract. A heterozygous PAX6 mutation in exon 5 (c.112delC, p.Arg38GlyfsX16) was identified in FAMILY-1, which was predicted to generate a frameshift and created a premature termination codon. A heterozygous PAX6 mutation in exon 7 (c.362C>T, p.Ser121Leu) was identified in FAMILY-2. Each mutation cosegregated with the affected individuals in the family and did not exist in unaffected family members and 200 unrelated normal controls. The PAX6 messenger ribonucleic acid level was about 50% lower in patients with aniridia than in unaffected family members in FAMILY-1. CONCLUSIONS: The deletion mutation (c.112delC) in the PAX6 gene was first identified in a Chinese family with aniridia, congenital progressive cataract, developmental delay, or the absence of ulna. The mutation (c.362C>T, p.Ser121Leu) in the PAX6 gene was first identified in a patient with aniridia with congenital ptosis. We summarized the variable phenotypes among the patients, which expanded the phenotypic spectrum of aniridia in a different ethnic background.

MicroRNA-204-5p regulates epithelial-to-mesenchymal transition during human posterior capsule opacification by targeting SMAD4.

PURPOSE: To investigate the role of microRNA (miRNA) in regulating epithelial-to-mesenchymal transition (EMT) during human posterior capsule opacification (PCO). METHODS: A miRCURY LNA microRNA array was used to evaluate the miRNA profiles of human PCO tissues and normal attached lens epithelial cells (LECs). An in vitro human donor capsular bag model was used to investigate the role of miRNAs in the EMT during PCO. The expression of SMAD4, phospho-SMAD2/3, and a panel of EMT markers was detected by Western blot and quantitative RT-PCR. RESULTS: The results of miRNA profiling in human PCO tissues and normal attached LECs demonstrated that, among other miRNAs, miR-204-5p expression was down-regulated. Using bioinformatics, we identified SMAD4, one of the mediators of TGF-ß/SMAD signaling, as a predicted target of miR-204-5p. Overexpression of miR-204-5p in primary LECs increased E-cadherin expression and decreased the expression of vimentin and alpha smooth muscle actin. Furthermore, miR-204-5p overexpression enhanced the repression of TGF-ß2-induced EMT in the presence of SMAD4 small interfering RNA. CONCLUSIONS: Our data provide firm evidence of a role for miR-204-5p in the direct regulation of EMT through its targeting of SMAD4 and, consequently, TGF-ß signaling. Because of its ability to repress the EMT, miR-204-5p may be a novel target for PCO therapeutic intervention.

Effects of preservation time on proliferative potential of human limbal stem/progenitor cells.

AIM: To determine the proliferative potential and the maintenance of stem cell activity in stored human limbal tissues, and correlate this with the preservation time, cell viability and the expression of stem cell markers. METHODS: Thirty limbal rims were split into 4 parts and stored in corneal preservation medium at 4°C for 0, 1, 4, or 7 days. The limbal stem cell and mitotic markers P63, CK19, proliferating cell nuclear antigen (PCNA), and Ki67 were determined by immunohistochemical staining. The proliferative potential of limbal epithelial cells was assessed by cell viability, the ability of generating stratified epithelium, and colony forming assay. RESULTS: The stored tissues maintained limbal stratified structure to 7 days and exhibited comparable expression level of stem cell and mitotic markers. The proportion of viable cells decreased with the prolonged preservation time, while colony forming efficiency decreased from the 1(st) day and disappeared at the 4(th) day. When inoculated on amniotic membrane, the cells preserved for 1 day formed a stratified epithelium, while the cells from 4 days' preservation formed a discontinuous layer. CONCLUSION: The colony forming efficiency of limbal epithelial stem/progenitor cells decreased rapidly with the increasing preservation time, while the expression level of markers and capacity of forming epithelial monolayer on amniotic membrane decreased gradually. The limbal epithelial stem cells lost their function earlier than the lost expression level of stem cell markers. This may help us to better choose the appropriate preservation grafts for future limbal stem cell transplantation.

Amniotic membrane traps and induces apoptosis of inflammatory cells in ocular surface chemical burn.

PURPOSE: Severe chemical burns can cause necrosis of ocular surface tissues following the infiltration of inflammatory cells. It has been shown that amniotic membrane transplantation (AMT) is an effective treatment for severe chemical burns, but the phenotypes of cells that infiltrate the amniotic membrane and the clinical significance of these cellular infiltrations have not previously been reported. The present work studies the inflammation cell traps and apoptosis inducing roles of the amniotic membrane after AMT in patients with acute chemical burns. METHODS: A total of 30 patients with acute alkaline burns were classified as having either moderate or severe burns. In all participants, AMT was performed within one week of his/her injury. After 7-9 days, the transplanted amniotic membranes were removed. Histopathological and immunohistochemical techniques were used for the examination and detection of infiltrating cells, and tests for the expression of CD (cluster of differentiation)15, CD68, CD3, CD20, CD57, CD31, CD147, and CD95 (Fas) were performed. A TUNEL (TdT-mediated dUTP nick end labeling) assay was used to confirm apoptosis of the infiltrating cells. Three patients with herpes simplex-induced keratitis who had undergone AMT to treat persistent epithelium defects were used as a control group. Amniotic membrane before transplantation was used as another control. RESULTS: After amniotic membrane transplantation, the number of infiltrating cells in patients with severe burns was significantly higher than in patients with moderate burns or in control patients (p<0.05). Among the severe burns patients, CD15 and CD68 were widely expressed in the infiltrating cells, and CD3, CD20, and CD57 were only found in a small number of cells. Occasionally, CD31-positive cells were found in the amniotic membranes. More cells that were CD147, Fas, and TUNEL positive were found in patients with severe burns than in patients with moderate burns or in control patients. CONCLUSIONS: Neutrophils and macrophages were the main cells that had infiltrated into the amniotic membrane during the acute phase of healing from a chemical burns. AMT can trap different inflammatory cells and induce apoptosis of inflammatory cells in acute ocular chemical burns.

High expression of p16INK4a and low expression of Bmi1 are associated with endothelial cellular senescence in the human cornea.

PURPOSE: Determine cyclin-dependent kinase inhibitor 2A (p16(Ink4a)) and polycomb ring finger oncogene (Bmi1) expression in corneal endothelium samples from different age groups and test whether the expression of p16(INK4a) and Bmi1 are associated with endothelial cellular senescence in human cornea. METHODS: Samples were selected from an eyebank of healthy human corneal endothelial cells (HCECs). Donor human corneas were divided into three age-groups: age ≤30 years, 30-50 years and ≥50 years. The expression of p16(INK4a) and Bmil were analyzed by real-time PCR, immunohistochemistry, and immunofluorescence. RESULTS: Through real-time PCR, we detected less than threefold decreases in Bmi1 expression and greater than fivefold increases in p16(INK4a) expression associated with aging. Bmi1 expression was significantly down-regulated with increasing donor age. The number of p16(INK4a)-positive cells was significantly higher and the number of Bmi1-positive cells was significantly lower in older donors compared to the younger age groups. Our immunohistochemistry experiments showed that the expression of p16(INK4a) in older donors was stronger than that in younger donors and the expression of Bmi1 in older donors was weaker than that in younger donors. Results from both the immunohistochemistry and real-time PCR experiments confirmed increased expression of p16(INK4a) and decreased expression of Bmi1 with age in HCECs. Additionally, the results of immunofluorescence double-staining for p16(INK4a) and Bmi1 further validated the immunocytochemistry and real-time PCR results. CONCLUSIONS: Our data are the first to demonstrate that high expression of p16(INK4a) and low expression of Bmi1 are associated with endothelial cellular senescence in human cornea. Our findings are not just for cornea transplantation but also for a better understanding of the cornea senescence and the process of aging in this specific human organ.

Safety evaluation of intracameral and subconjunctival injection of a novel mucoadhesive polysaccharide isolated from Bletilla striata in rabbit eye.

PURPOSE: To evaluate the safety of intracameral and subconjunctival injection of a novel mucoadhesive polysaccharide isolated from Bletilla striata in rabbit eye. METHODS: One hundred microliters (100 µL) of Bletilla striata polysaccharide (BsP) at concentrations of 10, 40, and 80 mg/mL was intracamerally or subconjunctivally injected into rabbit eyes. Phosphate-buffered saline and 10 mg/mL hyaluronic acid solution were also injected as controls. BsP safety was evaluated via clinical follow-up and histological analysis. The dead corneal endothelial cells were observed by vital staining with alizarin red and trypan blue at 14 days after intracameral injection. Finally, in the intracameral injection study, scanning electron microscopy was performed for evaluation of the structure of the corneal endothelium and anterior lens capsules. RESULTS: Subconjunctival injection of 10 mg/mL BsP does not cause pathological changes or an inflammatory response. Concentration greater than 10 mg/mL of BsP (40 or 80 mg/mL) leaded to a slight inflammatory response, but the rabbits recovered well in 3 days. The pathological observation further confirmed the safety of subconjunctival injection of BsP, and subconjunctival injection of 80 mg/mL BsP caused no lesion of the ocular tissues. Intracameral injection of 80 mg/mL of BsP did not cause a significant inflammatory reaction, and an even lower inflammatory response was observed in rabbits intracamerally injected with 40 or 10 mg/mL BsP. All rabbits intracamerally injected with BsP recovered within 7-14 days. BsP had little effect on the blood-aqueous barrier's integrity when the concentration was 10 mg/mL; at 40 or 80 mg/mL, a mild effect was observed, and the rabbits recovered in 1-3 days. Intracameral BsP injected at a concentration of 80 mg/mL had a negative impact on the corneal endothelium and lens, but concentrations of 40 or 10 mg/mL could be injected safely. CONCLUSIONS: BsP injection into the subconjunctival space and anterior chamber in rabbits at low concentrations (such as 10 mg/mL) did not have adverse effects.

Lymphocyte infiltration and activation in iris-ciliary body and anterior chamber of mice in corneal allograft rejection.

AIM: To investigate the infiltration and activation of lymphocyte in iris-ciliary body and anterior chamber after allogenic penetrating keratoplasty (PK), for further revealing the role of iris-ciliary body in corneal allograft immune rejection. METHODS: In the mice models of PK, BALB/C mice received orthotopic isografts (n =35) or C57BL/6 donor allografts (n =25). Grafts were examined daily for 3 weeks by slit-lamp microscopy and scored for opacity. The infiltration of CD4(+) T lymphocyte in iris-ciliary body and anterior chamber was examined by immunohistology and the mRNA of CD80 and CD86 in both cornea graft and iris-ciliary body by RT-PCR was analyzed in allograft recipient at days 3, 6, 10 and the day when graft rejection occurred. Isograft recipients were examined as control at the corresponding time points. Transmission electron microscope was used to study the ultrastructure, especially cell infiltration, of iris-cilary body and corneal graft at day 3, 7 and the day when rejection occurred after allogenic PK. RESULTS: Rejection was observed in all the allograft recipients followed more than 10 days, at a median time of 15 days (range 12-18 days), but not in any of isografts. CD4(+) T cells were first detected at day 6 after transplantation in limbus and Ciliary body, and then in the stroma of recipient, iris, anterior chamber and corneal allograft with an increased number until graft rejection occurred. CD80 and CD86 mRNA were detected under RT-PCR examination in both graft and iris-ciliary body of allograft recipient, but not in any of isograft recipient. Three days after operation, lymphocytes and monocytes macrophages were visible in iris blood vessels and the anterior chamber, and vascular endothelial cell proliferation and activation were significant under transmission electron microscopy examination. At day 7, corneal endothelial cells became thinner. Lymphocytes and mononuclear macrophages were found with great number in the anterior chamber and adhered to the corneal endothelium. Blood vessels in iris increased and were filled with lymphocytes. And lymphocytes were detected to migrate through endothelial cell gap out of vessels. When allograft rejection occurred, macrophages attached to endothelial cells with large number of lymphocytes and macrophages infiltrating in iris. CONCLUSION: Lymphocyte infiltration and activation occurred in iris-ciliary body after allogenic PK, and the lymphocytes could migrate from iris blood vessel to the anterior chamber, which might play an important role in corneal allograft immune rejection.

[Correlations of telomere length changing and pathogeny of keratoconus].

OBJECTIVE: To study telomere length, senescence-associated-beta-galactosidase (SA-beta-galactosidase) and senescence marker protein-30 (SMP-30) in the stromal cells of keratoconus or normal corneas respectively, aiming finding the association of these indexes with the phenotype of keratoconus. METHODS: Experiment research. 37 keratoconus lesions corneas were removed from 32 keratoconus patients who were operated in Shangdong Eye Institute between January 2006 and December 2006, and 20 normal corneas were collected from eye bank. The keratoconus corneas ages were from 13 to 34 years [mean ages (19 + or - 5) years] and the control group consists of 20 normal corneas donor ages from 9 to 30 years [mean ages (19 + or - 4) years]. And there was no statistical difference of ages between keratoconus and normal corneas. Southern blot method was utilized to detect telomere length of genomic DNA. SA-beta-galactosidase was detected by 5-bromo-4-chloro-3-indolyl-beta-D-galactopyranoside (X-Gal) staining method respectively in keratoconus and normal corneas. Isolated mRNA from keratoconus and normal corneas were reverse-transcribed to cDNA and SMP-30 was detected using PCR with specific primers (sense: 5' ccg tgg atg cct ttg act at 3'; anti-sense: 5' caa ctt cat gc tgct ttg ga 3'). To compare normal corneas and keratoconus corneas by histopathological study. Statistical analysis by t test. RESULTS: The telomere length in stromal cells in keratoconus corneas were from 10.29 to 14.12 kb, mean (11.54 + or - 1.41) kb, while that of normal corneas were from 12.64 to 15.32 kb, mean (13.45 + or - 0.99) kb. The difference of telomere length in stromal cells of keratoconus and normal corneas reached a statistical significant level (t = 4.753, P < 0.05). That means the telomere length of keratoconus stroma was shorter than that of normal corneal stroma. Light microscopy revealed that collagen fibers in keratoconus corneal stroma were arranged in an irregular manner. Cells density in keratoconus stroma appeared lower than in normal ones but the decrease was not significant. The staining of SA-beta-galactosidase in the keratoconus section was evident, but there was no staining in the normal corneas. SMP-30 was not detectable with RT-PCR method in either keratoconus or normal corneas. CONCLUSION: Telomeres in the keratoconus stromas manifest higher SA-beta-galactosidase than control, implying that improper senescence might be involved in pathogenesis of keratoconus.

Expression of senescence-related genes in human corneal endothelial cells.

PURPOSE: To investigate the expression of p16(INK4a), p21(WAF1/CIP1), p27(KIP1), and p53 in human corneal endothelial cell (HCEC) senescence ex vivo at various donor ages. METHODS: Residual corneal tissues obtained after penetrating keratoplasty were used in this study. Age, death-to-preservation interval, and preservation-to-surgery interval of the donors were recorded. Corneal endothelial cell survival and density were evaluated by trypan blue and alizarin red staining immediately after keratoplasty. Fresh frozen sections of donor corneas at various ages (18, 33, 54, and 68 years) were immunostained in situ. Total RNA extracted from age groups of 20, 30, 40, 50, and 60 years was evaluated by reverse-transcriptase polymerase chain reaction (PCR) to reveal the expression of the senescence-related genes, p16(INK4a), p21(WAF1/CIP1), p27(KIP1), and p53, in HCECs. Total RNA extracted from 20-, 24-, 26-, 30-, 50-, 55-, 56-, and 60-year-old donor groups was subjected to real-time PCR analysis for measurement of gene expression. The results of the young (< or =30 years) and the old (> or = 50 years) were compared by the unpaired t-test. Ex vivo senescence of HCECs from the donors at various ages (9, 17, 23, 57, 65, and 67 years) was observed by senescence-associated beta-galactosidase activity (SA-beta-Gal) staining at pH 6.0. RESULTS: The mean endothelial cell density of the donor corneas was 2,391.4+/-84.6 cells/mm(2), and the survival rate of the endothelial cells was 84.4%+/-5.3%. Hematoxylin and eosin staining showed normal structures of the corneal epithelium, stroma, and endothelium. The expression and nuclear localization of p16(INK4a), p21(WAF1/CIP1), p27(KIP1), and p53 in HCECs were confirmed by immunohistochemistry in situ. Reverse transcriptase PCR examination showed positive target bands of each gene at each age group. An age-related increase in p16(INK4a) expression was observed by real-time PCR (p=0.014). There was no significant difference in the expression levels of p21(WAF1/CIP1), p27(KIP1), and p53 between the young and old donors (p=0.875, 0.472, and 0.430, respectively). Strong SA-beta-Gal activity was observed in the endothelial cells of the old donors while there was weak and little-to-no blue staining in the endothelia from the young. CONCLUSIONS: The population of HCECs exhibiting senescence-like characteristics increases with age. p16(INK4a), p21(WAF1/CIP1), p27(KIP1), and p53 are expressed in HCECs despite donor ages. The p16(INK4a) signal pathway might play a key role in the process of senescence in HCECs.

Hyphal growth patterns and recurrence of fungal keratitis after lamellar keratoplasty.

PURPOSE: To evaluate growth patterns of fungal pathogens in corneas and recurrence of fungal keratitis after lamellar keratoplasty (LK). DESIGN: Retrospective noncomparative study. PARTICIPANTS: One hundred seventy-four patients (174 eyes) with fungal keratitis who underwent LK at Shandong Eye Institute from January 2000 through November 2006. METHODS: Medical records of each patient were retrospectively reviewed. Hyphal growth patterns in corneas were evaluated by histopathological examination. Fungal recurrence after LK was observed during the follow-up. MAIN OUTCOME MEASURES: Pathogens, hyphal growth patterns, and postoperative fungal recurrence. RESULTS: The pathogens were Fusarium (85.1%), Aspergillus (6.3%), Alternaria (4.6%), Penicillium (2.3%), and Candida (1.7%). Most Fusarium hyphae (91.2%) lay parallel to the corneal stromal lamellae, whereas most Aspergillus (90.9%) grew vertically. Recurrence of fungal keratitis was found in 15 patients (8.6%) after LK, and the pathogens were F. oxysporum (33.3%), F. solani (26.7%), F. moniliforme (13.3%), Aspergillus flavus (13.3%), Aspergillus fumigatus (6.7%), and Aspergillus terreus (6.7%). In cases of fungal recurrence, the majority of hyphae (80%) grew vertically. There was a higher recurrence rate in patients with vertically growing hyphae (46.2%) than in those with horizontally growing hyphae (2%) (chi(2) = 54.664, P<0.001), as well as in those with Aspergillus keratitis (36.4%) versus those with Fusarium keratitis (7.4%) (chi(2) = 10.031, P = 0.002). Reproducibility of the fungal recurrence rate was moderate in the patients with different hyphal growth patterns (kappa = 0.534) but poor in those with different fungal pathogens (kappa = -0.044). CONCLUSIONS: Hyphal growth patterns in corneas differ not only in the same fungal genus but also in the same species. The fungal recurrence rate after LK in patients with hyphae growing horizontally is much lower than that in those with hyphae growing vertically. Growth patterns of fungal pathogens may be an important factor for fungal recurrence after LK.

[Transfer of endostatin gene for inhibition of retinal angiogenesis in mice].

OBJECTIVE: To evaluate the effect of liposome mediated plasmids encoding endostatin (ES) injected into the vitreous to inhibit experimental retinal neovascularization. METHODS: Cationic liposome mediated ES expression plasmid PCDNA(3)-ES was constructed. One-week-old C57Bl/6N mice were exposed to (75 +/- 2)% oxygen for 5 days, then returned to the room air to induce retinal neovascularization. Cationic liposome mediated ES complex (2 microl) was injected into the vitreous in the treatment group. PBS 2 microl or liposome with carrier DNA complex were injected in the control group. The ES protein expression in the retina was tested with immunohistological methods at 1, 3, 7 and 14 days after injection. Retinal neovascularization was evaluated by angiography with injection of fluorescein dextran and quantification of neovascular proliferative retinopathy after 5 days in room air. To examine the toxicity of the liposome and plasmid PCDNA(3)-ES complex, the histological changes in the retina were examined by light and electron microscopy. RESULTS: ES protein was expressed in the retina 24 hours after injection. Most of them presented in the retinal ganglion layer. This could last for 2 weeks at least. Retina of the PBS-injected eyes of retinal neovascular animal model showed prominent neovascular tuft and fluorescein leakage. Fewer neovascular tufts could be seen after ES injection. Retinal neovascularization in the eyes injected with ES plasmids complex was reduced as compared with the control group. No side effect on the retina was observed by light and electron microscopy. CONCLUSIONS: Liposome mediated plasmids encoding ES can be transferred to retinal cells by vitreous injection and can suppress retinal neovascularization, no side or toxic effects are presented in the retina. Further studies should be done to improve the treatment results.

[Organ culture for preservation of the cornea: human umbilical cord serum versus fetal bovine serum].

OBJECTIVE: To evaluate the changes of porcine corneal endothelium, the morphology, histology, ultrastructure, enzymes activity and metabolism of the cornea induced by organ culture with two different media containing fetal bovine serum (FBS) or human umbilical cord serum (HCS). METHODS: Fifty pairs of porcine corneas were preserved at 31 degrees C for 7, 14, 21, 28 days. One cornea of each pair was cultivated in medium I containing 10% FBS (group 1); the other one was stored in medium II containing 10% HCS (group 2). Thirteen fresh porcine corneas served as controls. All stored corneas were dehydrated for 24 hours. Twelve corneas from each group were evaluated each week, including the morphology, histology and enzyme histochemical staining of the cornea. Scanning electron microscopy was performed on one cornea from each group at 14 and 28 days and compared with the fresh cornea. pH value, glucose and lactate concentration of the culture media before and after culture were examined. Microbiological evaluation was also performed. RESULTS: Endothelium evaluation did not differ statistically between the two groups of porcine corneas. The morphological endothelium study showed some alterations such as pleomorphism. After 28 days of cultivation, the mean cell losses of endothelium were 10.98% and 10.85% in medium I and medium II stored corneas, respectively. There were no statistical differences of the histology, ultrastructure and enzymes activity of corneas between the two groups. The histological study showed corneal swelling and epithelial sloughing after preservation. Scanning electron microscopy showed an intact endothelial layer in all corneas. Enzyme histochemical staining showed vigorous enzyme activity in the corneal epithelium and endothelium. Enzyme activity in stroma decreased with preservation time. Corneas showed good glucose metabolism. Incidence of contamination was 6% for storage medium. CONCLUSIONS: The corneal endothelium can maintain a good viability for 4 weeks in these two organ culture media. HCS can replace FBS in the organ culture medium.