To specify various types of corneal disorders, diagnosed through meticulous slit-lamp examinations of donor corneas, which make the tissues unsuitable for transplantation.

All slit-lamp biomicroscopic records of donor corneas in the Central Eye Bank of Iran between 2006 and 2013 were reviewed and various types of corneal disorders that had made the tissues unsuitable for transplantation. The histopathologic records of the unsuitable corneas were also reviewed.

Slit-lamp biomicroscopic records of 50,229 donor corneas were reviewed, from which 733 (1.5%) corneas were diagnosed unsuitable for transplantation due to the presence of corneal infiltrations (n=383, 52.3%), corneal stromal opacities (n=292, 39.8%), keratoconus (n=48, 6.5%), epidemic keratoconjunctivitis (n=6, 0.8%), and corneal dystrophies (n=4, 0.6%). Histopathologic evaluations were consistent with the slit-lamp diagnoses.

Corneal infiltrations and stromal opacities were the leading causes of unsuitability of corneal tissues for transplantation. When performed by an experienced and well-trained eye bank technician, slit-lamp biomicroscopic examination of the donor corneas plays a critical role in detecting unsuitable corneas for transplantation.