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Contamination in McCarey-Kaufman stored keratoplasty donor material
Abstract:
One hundred consecutive donor corneas which had been preserved in McCarey-Kaufman medium and used in actual keratoplasties were studied. The residual medium and button remnants were cultured for bacterial and fungal growth. Coagulase-positive staphylococci were recovered in three cases, coagulase-negative staphylococcus in one and Rhodotorula sp. in another; no associated postoperative infections were reported, although one patient was regrafted 48 hours after the initial keratoplasty for "graft decompensation"--the initial button was not submitted for reculture. One additional specimen was processed. A cracked vial with clear contained fluid was held for culture; Pseudomonas cepacia was grown from the fluid. Other samples in undamaged vials from the same lot did not show contamination.
Insights
Microbial contamination in donor corneas preserved in McCarey-Kaufman medium is uncommon. Cultures revealed bacteria and fungi, but no associated postoperative infections were reported in this keratoplasty study.
Area of Science:
- Ophthalmology
- Microbiology
- Transplantation Science
Background:
- Donor cornea preservation is crucial for successful keratoplasty.
- McCarey-Kaufman medium is a common storage solution.
- Microbial contamination can compromise graft outcomes.
Purpose of the Study:
- To assess the microbial contamination rate of donor corneas preserved in McCarey-Kaufman medium.
- To identify specific microorganisms present in preserved donor corneas.
- To correlate microbial findings with postoperative outcomes in keratoplasty.
Main Methods:
- Culturing residual medium and corneal button remnants from 100 donor corneas.
- Bacterial and fungal growth identification.
- Review of postoperative infection data for patients receiving these corneas.
Main Results:
- Microbial growth was detected in 5 out of 100 specimens.
- Identified organisms included coagulase-positive staphylococci, coagulase-negative staphylococcus, Rhodotorula sp., and Pseudomonas cepacia.
- Pseudomonas cepacia was isolated from a cracked vial, not from intact corneal samples.
- No postoperative infections were reported in association with the contaminated corneas.
Conclusions:
- While microbial contamination of donor corneas preserved in McCarey-Kaufman medium can occur, it appears infrequent.
- The identified microorganisms did not lead to reported postoperative infections in this cohort.
- Proper vial integrity is critical to prevent contamination, as demonstrated by the Pseudomonas cepacia finding.