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Updated: Aug 4, 2026
Corneal Donor Tissue Preparation for Endothelial Keratoplasty
Published on: June 12, 2012
Positive donor rim culture in penetrating keratoplasty
1Cornea Service, Wills Eye Hospital, Philadelphia, Pennsylvania 19107, USA.
Abstract:
A 3-year retrospective study on the risk factors of positive donor rim cultures in penetrating keratoplasty was performed. One thousand and ninety-seven consecutive donor rim cultures were reviewed from the period between June 1990 and October 1993 to determine the rate of culture positivity. The sex, age, diabetes status, use of respirator at time of death, cause of death, harvesting technique, storage time, and corneal storage medium utilized for the donors with positive donor rim culture were compared to those for 100 randomly selected culture negative donor controls. Logistic analysis was performed to eliminate confounding effects. Forty-six of the 1,097 (4.19%) donor rim cultures were positive. We found an association between the in situ technique for donor harvesting and culture negativity (p = 0.03). None of the other donor characteristics was associated with culture positivity. None of the 46 recipients who received the positive culture corneas developed endophthalmitis. In situ cornea harvesting promotes less contamination than enucleation and enriched gentamicin and streptomycin storage medium may further decrease donor rim culture positivity.
Insights
In situ cornea harvesting reduces contamination in donor rims, decreasing positive cultures in penetrating keratoplasty. Enriched storage media may further lower contamination rates.
Area of Science:
- Ophthalmology
- Microbiology
Background:
- Donor rim cultures are crucial for assessing microbial contamination in corneal transplantation.
- Understanding risk factors for positive cultures is vital for improving graft success rates.
Purpose of the Study:
- To identify risk factors associated with positive donor rim cultures in penetrating keratoplasty.
- To evaluate the impact of harvesting techniques and storage media on microbial contamination.
Main Methods:
- Retrospective review of 1,097 donor rim cultures from June 1990 to October 1993.
- Comparison of donor characteristics (sex, age, diabetes, cause of death, harvesting, storage) between positive and negative culture groups.
- Logistic analysis to identify significant associations with culture positivity.
Main Results:
- A 4.19% positivity rate was observed in donor rim cultures.
- In situ cornea harvesting was associated with significantly lower culture positivity (p=0.03).
- No recipient of corneas from positive cultures developed endophthalmitis.
Conclusions:
- In situ cornea harvesting technique is associated with reduced microbial contamination compared to enucleation.
- Enriched storage media containing gentamicin and streptomycin may further decrease donor rim culture positivity.
- Positive donor rim cultures did not correlate with post-keratoplasty endophthalmitis in this cohort.
