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Bishoy O. Said, Sumit Garg, Marjan Farid, Roger F. Steinert; Prevalence of Positive Microbiology Results from Donor Cornea Tissue in Corneal Transplantation from 2006-2010 and Subsequent Clinical Outcomes. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6174.
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To evaluate the rate of positive microbiology results (culture and/or gram stain) in donor cornea tissue with newer transplant methods and to assess if this subsequently correlates with higher rates of clinical infection.
A retrospective chart of review of the microbiology records of 569 consecutive cornea transplants from July 2006 through July 2010 at the Gavin Herbert Eye Institute was performed to evaluate for positive cultures and/or gram stain results in routine evaluation of cornea donor tissue. A chart review was then conducted to evaluate the clinical significance of microbiologic findings of all positive cultures as well as all patients that had no culture results.
Microbiologic results were available for 544 of 569 transplants (95.6%). Overall, 46 (8.5%) positive reports occurred. Subgroup analysis revealed the rate of positive results was 6/137 (4.4%), 14/127 (11.0%), and 26/271 (9.6%) for femtosecond laser keratoplasty (FLK), descemet stripping automated endothelial keratoplasty (DSAEK), and conventional penetrating keratoplasty (PKP), respectively; ten femtosecond deep anterior lamellar keratoplasty (DALK) had no positive results. The overall rate of documented clinical infection was found to be 0.3% (2/569). However, only one case (1/569, or 0.18%) was attributable to the donor. Of 25 cases in which microbiology studies were not performed, none developed a clinical infection.
Rates of positive microbiologic results and subsequent infections do not appear to be increased with newer techniques for corneal transplantation. Despite increased manipulation of tissue in new methods of keratoplasty, this did not translate into higher rates of positive microbiologic results or clinical infection compared to published reports.
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