In order to evaluate donor corneas with the CellChekD specular microscope, corneas need to be warmed up. The effect of temperature on the endothelial cell’s ability to pump influences image quality. When the donor cornea is kept at 4-8 degrees, all the metabolic activities, such as pumping, drastically slow down.
When the cornea is cold, cells are swollen and borders are widened, creating an irregular surface, which affects the ability to capture a good image.
The cornea must be warmed up for metabolic pumping to be fully activated and improve the image quality.
A common way to warm the cornea is to leave the cornea outside refrigeration, until it reaches room temperature. However, it is hard to know how long and what temperature. Depending on the cornea it may take a couple of hours to get to the room temperature. Also, room temperature varies from eye bank to eye bank.
There are so variables when it comes to warming up the cornea that we started to suggest the use of a temperature-controlled incubator. Corneas are happiest in the body (35-37 degrees C). Placing the cornea in the incubator at 30-35C, perhaps 30 min to an hour, really helps sped up warming time effectively and improves image quality much faster. Initially we got a lot of resistance to that idea. A few eye banks were already using incubator before we suggested it. VisionGift (Oregon) and some other eye banks did the safety studies and published them.
The effect of temperature on the endothelial image quality.
Temperature Reversal showing the effect of warming vs increase of metabolic pump activation.
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