Question

Which of the following statements regarding corneal transplantation is true?

• A. Whole eye needs to be preserved in tissue culture
• B. Donor not accepted if age is more than 60 years
• C. Specular microscopy analysis is used to assess endothelial cell count
• D. HLA matching is mandatory

Hint:

Graft survival depends on the endothelial pump, so the key quality test counts endothelial cells.

Answer 1

The Correct Option is C

Step 1: The cornea is avascular. Its clarity depends on the corneal endothelium, a single layer of cells that pumps water out of the stroma. The quality of donor tissue is judged mainly by endothelial cell density.
Step 2: Specular microscopy projects light onto the donor cornea and images the endothelial mosaic. It counts cells per square millimetre and assesses their shape. A healthy graft usually needs more than about 2000 cells per square millimetre. So option C is correct.
Step 3: Option A is wrong. The whole eyeball is not kept in tissue culture. The corneoscleral disc is excised and stored in media such as McCarey-Kaufman medium or organ culture; the whole globe is only briefly preserved by moist chamber storage.
Step 4: Option B is wrong. Older donors are commonly used. Age above 60 years is not an absolute bar; suitability depends on endothelial count, not a strict age cutoff.
Step 5: Option D is wrong. Routine corneal grafting does not need HLA matching because the cornea is avascular and immune privileged. HLA matching is only considered in high-risk vascularised corneas.
Hence the answer is Option C: Specular microscopy analysis is used to assess endothelial cell count.