Abstract
Purpose:
To assess characteristics of donor corneal tissues with positive scleral rim cultures and postkeratoplasty infections.
Methods:
Retrospective review of 2,681 consecutive corneal transplants with donor scleral rim bacterial cultures performed from 1997-2011 at a single center. Data collected included: donor cornea characteristics from the eye-bank database, surgery performed, microbiology laboratory reports, and post-operative course. Statistical analysis was performed with SAS 9.3.
Results:
Of 2,681 transplants, there were 72 (2.7%) with positive cultures of the donor scleral rim. None of those patients developed clinical infection. The two most common organisms cultured were coagulase negative staphylococcus (23%) and candida (18%). There was 1 (0.04%) case of endophthalmitis and 5 (0.2%) cases of keratitis seen within the first 90 days after surgery, all with negative scleral rim cultures. There was no statistically significant difference in the rate of positive cultures in DSAEK (2.6%) versus PKP (2.4%) tissue, p = 0.79. There was no statistically significant difference in the rate of postkeratoplasty infection in DSAEK versus PKP tissue, p = 0.70. There were no statistically significant differences in donor characteristics of the tissues with positive scleral rim cultures or postkeratoplasty infections, including age, sex, race, death to procurement time, or death to surgery time. There were also no statistically significant differences in corneal tissue characteristics, including corneal thickness, endothelial cell density, or tissue type (whole cornea versus pre-cut).
Conclusions:
In this cohort of 2,681 corneal transplants there were no donor or corneal tissue characteristics that correlated with positive donor scleral rim cultures or postkeratoplasty infection. Interestingly, there was no relationship between positive donor scleral rim culture and postkeratoplasty infections.
Keywords: 479 cornea: clinical science •
463 clinical (human) or epidemiologic studies: prevalence/incidence