Abstract
Purpose :
The antiseptic washing of donor ocular tissue prior to recovery has made post-operative infection complications rare. In October 2018, the Eye Bank Association of America modified the national standard to incorporate two povidone-iodine (PI) rinses of donor corneoscleral rim tissue at the time of procurement. This study aims to determine if this new procedure reduces the rate of positive donor rim cultures.
Methods :
A comprehensive database review was performed on consecutive corneoscleral tissue handled by the Eye-Bank for Sight Restoration (New York, NY, USA) from January 2015 to December 2021, as NY requires donor cultures of all corneal transplant tissue. The primary outcome was the rate of positive corneoscleral rim cultures. Secondary outcomes included rate of post-operative infection.
Results :
During the study period, there were 6079 corneal transplants performed, of which 3491 were done prior to implementation of the double PI wash protocol with a total culture positive rate of 0.32%. After implementation of the double PI wash, there were 2588 corneal transplants with a total positive culture rate of 0.19% (Poisson regression coefficient .00164, p = 0.006). The most common organisms pre-implementation were Candida species (45.5% of culture positive rims), whereas no candida species were isolated post-implementation (logit regression, p = 0.034). The C. acnes culture positivity rate increased post-implementation (60.0% of culture positive rims) versus 18.1% pre-implementation (logit regression, p = 0.093). The pre- and post-implementation rate of post-op infection was 0.17% and 0.08% respectively (Poisson regression coefficient 0.00198, p = 0.028).
Conclusions :
The establishment of a double PI wash was associated with a general decrease in the incidence of positive donor corneoscleral rim, with a notable decrease in Candida species growth, and a decrease in post-operative infections.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.