PubMed · 3076699
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R G Notz, D Derck. 1988. Practical specular microscopy.. https://pubmed.ncbi.nlm.nih.gov/3076699/
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Recipients enrolled in the Collaborative Corneal Transplantation Studies were retyped as part of a quality assurance program. Because the observed percentage of HLA-DR homozygosity on original typing was more than twice as high as expected from CCTS allele frequencies, the sample selected for retyping was heavily weighted with patients whose original typing identified fewer than two DR antigens. Retyping was performed in a different laboratory from the laboratory performing the original typing. For the 129 patients who were retyped, agreement between the original and retyping laboratories was 88% for HLA-A, 79% for HLA-B, and 55% for HLA-DR. When criteria was relaxed to consider only discrepancies involving readily identifiable antigens, the agreement improved to 95% for HLA-A, 91% for HLA-B, and 59% for HLA-DR. Identification of a second HLA-DR antigen on retyping when only one DR antigen had been identified on original typing was by far the most common form of disagreement. There were no significant differences in the amount of disagreement among the laboratories. Of special interest is that 50% of the discrepancies involved DR3, DR5, and/or DR6, which have structural similarities. Based on the results of the project, we recommend: (1) replicate testing for all DR typing; and (2) retyping using a second source of antiserum for all subjects having DR blanks.
The microsurgical processing of longterm preserved tissue is still a problem for lamellar and perforating keratoplasties. Advantages of donor tissue cut with rotortrephines versus manual trephines are presented. Optimal possibilities of examination and storage of donor tissue are explained. A lamellar microkeratome, an artificial anterior chamber for corneoscleral discs and a refractive workbench for non-freeze modification are shown.
The longterm tissue culture is performed at the University Eye-Hospital of Hamburg since 1985 with a standardized procedure. The number of donor material and operations in the first 7 months of 1991 are reported. Preparation, storing and HLA-typing of the tissue are considered. The technical working up of the stored tissue for penetrating and lamellar keratoplasties will be explained.