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Updated: Dec 16, 2025
Corneal Donor Tissue Preparation for Endothelial Keratoplasty
Published on: June 12, 2012
Intensive care unit time and prolonged enucleation to processing interval are associated with donor cornea
Isabella Funfas Bandeira Medina1, Ana Paula Miyagusko Taba Oguido2, Mariana Ragassi Urbano3
1Postgraduate Program in Health Sciences Center, State University of Londrina (UEL), Londrina, PR, Brazil. isabellafbandeiramedina@gmail.com.
Purpose:
To determine donor cornea contamination rate and to determine factors associated with cornea contamination. To assess the effect of hospitalization, intensive care unit (ICU) time, and antibiotic use on corneal contamination rate. To determine the spectrum of the contaminating microorganisms.
Methods:
The contamination rate of 212 corneas, obtained by enucleation from April 2014 to January 2015 in a single eye bank, was assessed retrospectively according to age, sex, cause of death, systemic antibiotic use, hospitalization time, ICU time, mechanical ventilation (MV), death to enucleation interval (DEI), enucleation to processing interval (EPI), and corneal epithelial exposure grading. The relative risk (RR) and adjusted RR with a 95% confidence interval were calculated using IBM-SPSS 20.0.
Results:
The contamination rate was 35.6% (n = 75). On multivariate analysis, ICU stay of 4 days or longer and enucleation to processing interval (EPI) greater than 7.4 h (RR 1.58, CI 0.96-2.60, P = 0.06) were associated with donor cornea contamination. Corneal contamination risk was highest from 4 to 6 days at the ICU (RR 3.40, CI 1.54-7.51, P < 0.01) and decreased after 7 days (RR 2.22, CI 1.00-4.93, P = 0.05). Coagulase-negative Staphylococcus was the most common isolated bacteria (69.6%). The frequency of gentamicin-resistant bacteria was higher among patients who stayed 4 days or longer at the ICU.
Conclusion:
Patients staying at the intensive care unit 4 days or longer showed increased risk of corneal contamination. This is an important result to consider further indication for cornea donation.
Insights
Donor cornea contamination is linked to extended intensive care unit (ICU) stays. Patients in the ICU for four days or more face a higher risk of corneal contamination, impacting cornea donation suitability.
Area of Science:
- Ophthalmology
- Microbiology
- Public Health
Background:
- Corneal transplantation is a common procedure to restore vision.
- Donor cornea quality is crucial for successful transplantation outcomes.
- Microbial contamination of donor corneas can lead to graft failure and vision loss.
Purpose of the Study:
- To determine the contamination rate of donor corneas.
- To identify factors associated with donor cornea contamination, including intensive care unit (ICU) stay and antibiotic use.
- To characterize the spectrum of microorganisms responsible for corneal contamination.
Main Methods:
- A retrospective analysis of 212 donor corneas obtained from a single eye bank.
- Assessment of contamination rates based on various donor factors: age, sex, cause of death, hospitalization time, ICU time, mechanical ventilation, death-to-enucleation interval, enucleation-to-processing interval, and corneal epithelial exposure.
- Statistical analysis using relative risk (RR) and adjusted RR with 95% confidence intervals.
Main Results:
- The overall donor cornea contamination rate was 35.6%.
- Multivariate analysis revealed that an ICU stay of 4 days or longer and an enucleation-to-processing interval exceeding 7.4 hours were associated with increased contamination risk.
- Corneal contamination risk was highest between 4 to 6 days in the ICU, with a notable increase in gentamicin-resistant bacteria among patients with prolonged ICU stays.
Conclusions:
- Prolonged intensive care unit (ICU) stays, particularly 4 days or longer, significantly increase the risk of donor cornea contamination.
- The findings suggest a need to reconsider donor selection criteria and potentially implement enhanced screening for corneas from donors with extended ICU stays.
- Coagulase-negative Staphylococcus was the predominant contaminant, highlighting the importance of vigilant microbiological surveillance in eye banking.
