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Increasing Povidone-Iodine Exposure in Endothelial Keratoplasty Tissue Processing and Fungal Infection Impact

C Drew Salisbury1, Carter N Kirk2, W Barry Lee1,3

  • 1Cornea Service, Eye Consultants of Atlanta and Piedmont Hospital, Atlanta, GA.

Cornea
|June 7, 2019
PubMed
Abstract

Insights

Doubling povidone-iodine exposure during corneal donor recovery significantly reduced fungal and bacterial rim cultures and postoperative fungal infections. This enhanced protocol improves corneal transplant safety.

Area of Science:

  • Ophthalmology
  • Microbiology
  • Surgical Infection Prevention

Background:

  • Corneal transplantation (keratoplasty) relies on donor tissue.
  • Infection risk is a concern in corneal allografts.
  • Standardized protocols for donor tissue preparation are crucial.

Purpose of the Study:

  • To assess the impact of increased povidone-iodine exposure time on donor rim cultures.
  • To evaluate the effect on postoperative infection rates after keratoplasty.
  • To determine if doubling povidone-iodine exposure impacts corneal epithelial toxicity.

Main Methods:

  • A retrospective analysis of donor cornea recoveries was performed.
  • Rim cultures and postoperative infections were compared before and after protocol change.
  • Povidone-iodine exposure time was doubled during donor preparation.

Main Results:

  • Positive fungal rim cultures decreased from 2.9% to 0.6%.
  • Positive bacterial rim cultures decreased from 6.5% to 4.0%.
  • Postoperative fungal infections decreased from 0.48% to 0%, with no bacterial infections.

Conclusions:

  • Increased povidone-iodine exposure time significantly reduces microbial contamination of donor corneas.
  • This protocol modification is effective in lowering infection rates in keratoplasty.
  • No adverse effects on corneal epithelial health were observed.

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