Organ culture: the method of choice for preservation of human donor corneas.

The first successful penetrating keratoplasty in a human was performed as early as 1906 by Zirm. The tissue was obtained from the eye of a living donor requiring enucleation. Much has changed since then. Advances in surgical instrumentation and techniques and the introduction of antibiotics and corticosteroids in the 1950s significantly improved the success rate of corneal transplantation. Consequently, the demand for donor tissue increased. On the one hand, the supply was enhanced by the possibility of using eyes from human cadavers. On the other hand, attempts were made to increase the storage time for cadaveric tissue while maintaining the integrity of the endothelial layer. The importance of the corneal endothelium for the maintenance of corneal clarity was convincingly demonstrated by Stocker. At about the same time in the 1970s two methods for storage of excised human corneoscleral buttons were introduced in the USA and are currently still applied: hypothermic storage 5 and organ culture preservation.