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Incidence and Outcomes of Positive Donor Rim Cultures and Infections in the Cornea Preservation Time Study

Shahzad I Mian1, Anthony J Aldave2, Elmer Y Tu3

  • 1Kellogg Eye Center, University of Michigan, Ann Arbor, MI.

Cornea
|June 19, 2018
PubMed
Abstract

Insights

Longer corneal preservation time did not increase positive donor rim cultures. Overall postkeratoplasty infection rates were low, with surgeon-prepared tissue a risk for fungal growth.

Area of Science:

  • Ophthalmology
  • Microbiology
  • Transplantation Science

Background:

  • The Cornea Preservation Time Study (CPTS) aimed to evaluate donor rim culture results and subsequent ocular infections.
  • Donor corneal rim cultures were optional, with data collected on donor characteristics and infection incidence.

Observation:

  • Cultures were performed on 784 of 1330 donor corneas.
  • Positive fungal cultures were 2.5% (0-7 days) vs. 1.3% (8-14 days), and bacterial cultures were 1.5% vs. 1.0%, with no significant difference based on preservation time.
  • Surgeon-prepared tissue increased fungal culture risk (RR 2.85), younger donors and accidental death donors increased bacterial culture risk.

Findings:

  • A longer preservation time did not correlate with an increased rate of positive donor rim cultures.
  • The overall incidence of postkeratoplasty fungal infection was 0.15% and bacterial infection was 0.08%.
  • One recipient with a positive fungal culture developed Candida glabrata infection; no recipients with positive bacterial cultures developed infections.

Implications:

  • Corneal preservation time appears safe regarding microbial contamination.
  • Surgeon preparation methods and donor characteristics are critical factors influencing microbial risk in corneal transplantation.
  • These findings support current practices while highlighting areas for improved donor tissue screening and preparation.

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