Comparison of Corneal Endothelial Cell Density and Morphology With Optisol-GS and Life4C Storage Media in the Eye Bank: A 5-Year Retrospective Analysis

Abstract

Optisol-GS and Life4C are corneal storage media used by eye banks worldwide. We sought to determine whether either solution was associated with superior corneal endothelial cell density (ECD) or morphology in a large cohort of donor corneas. From January 2016 to December 2020, 10,316 corneas from 5624 unique donors were acquired and analyzed at Rocky Mountain Lions Eye Bank. In April 2019, Life4C replaced Optisol-GS as the sole storage medium. We compared ECD and morphology before and after April 2019 and excluded corneas processed within the transition period. Univariable and multivariable regression analyses accounted for age, sex, tobacco use, heavy alcohol use, and diabetes. Only right corneas were analyzed to account for the correlation between eyes. Of 5042 right corneas analyzed, 3486 were stored in Optisol-GS and 1556 in Life4C. There was no significant difference in ECD across groups (2794 vs. 2793 cells/mm2 in Optisol-GS and Life4C, P = 0.88). In multivariate analyses, there was no significant difference in corneal ECD (0.6 cells/mm2 higher with Life4C, P = 0.96) or hexagonality (0.22% higher with Life4C, P = 0.31). However, the coefficient of variation was significantly lower in the Life4C group (−0.0039, P = 0.03). After adjustment for above factors, corneas in Life4C demonstrated a 3.1% decreased likelihood of exhibiting coefficient of variation (CV) values greater than 0.40 (P = 0.009). This study demonstrates comparable and favorable outcomes using both storage media and confirms their overall efficacy. The decreased CV in Life4C is not of clinically significant magnitude but merits further research in clinical and long-term settings.