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Updated: Feb 28, 2026
Corneal Donor Tissue Preparation for Endothelial Keratoplasty
Published on: June 12, 2012
Pre-banking microbial contamination of donor conjunctiva and storage medium for penetrating keratoplasty
Takenori Inomata1, Koichi Ono2, Tsuyoshi Matsuba3
1Department of Ophthalmology, Juntendo University Faculty of Medicine, Bunkyo-ku, 2-1-1 Hongo, Tokyo, 113-0033, Japan. tinoma@juntendo.ac.jp.
Purpose:
The aims of this study were to investigate the incidence of positive donor tissue cultures before transfer to preservation medium (Optisol™-GS) for penetrating keratoplasty, to verify the efficacy of antibiotics contained in Optisol™-GS by examining the drug susceptibility and to assess the relationship between the results of our microbial assessments as well as donor factors and the incidence of contamination.
Methods:
We conducted a retrospective, cross-sectional study using Juntendo Eye Bank records for all corneal transplantations. Two hundred donor conjunctiva harvestings and storage medium (EP-II®) cultures were performed between July 2008 and June 2011. We analyzed the associations between donor factors (age, gender, history of cataract surgery, death-to-preservation interval, cause of death) and contamination rates using multivariate analysis by the generalized estimating equation model.
Results:
We obtained positive bacterial cultures from 154 of the 200 eyes (77.0%). The isolated bacteria were indigenous, such as coagulase-negative Staphylococci, Corynebacterium sp., and methicillin-resistant Staphylococcus aureus (MRSA). There was significant resistance to levofloxacin (18 eyes, 9.0%) and gentamicin (12 eyes, 6.0%), and no vancomycin-resistant bacteria were detected. The donor factors did not correlate with the prevalence of bacterial contamination in our criteria.
Conclusions:
Pre-banking microbial assessment allows for microbial detection, bacterial susceptibility and resistance testing. This is useful for developing preservation mediums containing effective spectrum antibiotic agents for high quality control of corneal banking.
Insights
High incidence of bacterial contamination was found in donor corneas before preservation. Donor factors did not influence contamination, but antibiotic resistance was noted, highlighting the need for effective preservation media in corneal banking.
Area of Science:
- Ophthalmology
- Microbiology
- Transplantation Science
Background:
- Corneal transplantation, specifically penetrating keratoplasty, relies on donor tissue quality.
- Preservation media, such as Optisol™-GS, are crucial for maintaining tissue viability and preventing microbial contamination.
- Pre-transfer microbial assessment of donor tissue is essential for quality control.
Purpose of the Study:
- To determine the incidence of positive bacterial cultures in donor corneas prior to preservation.
- To evaluate the efficacy of antibiotics in Optisol™-GS by assessing bacterial drug susceptibility.
- To explore the correlation between donor characteristics and microbial contamination rates.
Main Methods:
- A retrospective cross-sectional study analyzed 200 donor conjunctiva and storage medium cultures from July 2008 to June 2011.
- Multivariate analysis using the generalized estimating equation model was employed to assess donor factors (age, gender, cataract surgery history, death-to-preservation interval, cause of death) and contamination rates.
- Bacterial isolates were identified, and their susceptibility to antibiotics was tested.
Main Results:
- A high incidence of positive bacterial cultures (77.0%) was observed in donor eyes.
- Common indigenous bacteria, including coagulase-negative Staphylococci, Corynebacterium sp., and methicillin-resistant Staphylococcus aureus (MRSA), were isolated.
- Significant antibiotic resistance to levofloxacin (9.0%) and gentamicin (6.0%) was detected, with no vancomycin resistance found.
- Donor factors showed no significant correlation with the prevalence of bacterial contamination.
Conclusions:
- Pre-banking microbial assessment is vital for detecting contamination and guiding antibiotic selection.
- The study identified significant antibiotic resistance, underscoring the importance of developing preservation media with effective antibiotic spectra.
- Enhanced quality control in corneal banking through microbial assessment ensures higher quality donor tissue for transplantation.
