Purpose: To evaluate demographic, clinical, and microbiological profile of eye donors and efficacy of 0.3% gatifloxacin hydrochloride in microbial decontamination of donor corneas.
Methods: About 513 donors and 1,026 corneas received at National Eye Bank of a tertiary care hospital during 1-year period were analyzed prospectively in this randomized clinical trial. The donor eyes were graded and treated with 5% povidone-iodine, 0.4% amikacin sulphate, and 0.3% gatifloxacin hydrochloride. The parameters evaluated were death enucleation time (DET), grading of donor corneas, microbiological profile of culture organisms, and their sensitivity to various antibiotics.
Results: Mean DET was 6.29±5.7 hours. Forty one percent eyes were optical grade corneas and the majority of donors (38.5%) had accidental deaths. Good grade eyes were maximum with DET of <1 hour and were comparable between 0–6 hours and 6–12 hours. About 57.6% (591/1026) eyes were culture positive; most common organisms were Pseudomonas spp (53%) and Coagulase-negative Staphylococci (24%). Culture positivity reduced significantly after treatment with povidone iodine and amikacin (P=0.002, right eye; P=0.004; left eye) and decreased further with use of gatifloxacin (P=0.001). Pseudomonas (93%), Coagulase-negative Staphylococci (96.3%), Staphylococcus aureus (90.5%), enterococci and gram-negative bacilli were sensitive to gatifloxacin. Pseudomonas spp which were multidrug-resistant were sensitive to polymyxin-B.
Conclusions: Gatifloxacin hydrochloride in addition to amikacin sulphate is beneficial for donor eye decontamination. Polymyxin-B may be used for multidrug-resistant Pseudomonas spp.
Dr Rajendra Prasad Centre for Ophthalmic Sciences (N.S., A.S., R.S., R.T., J.S.T., G.S., S.S., R.B.V.), All India Institute of Medical Sciences, New Delhi, India; Division of Ocular Microbiology (G.S.), Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India; Division of Ocular Pathology (S.S.), Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India; and Centre for Eye Research Australia (R.B.V.), Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Australia.
Address correspondence and reprint requests to Namrata Sharma, M.D., Additional Professor, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India; e-mail: firstname.lastname@example.org
Presented as a poster in World Cornea Congress VI, April 7–9, 2010, Boston, MA.
The authors have no funding or conflicts of interest to disclose.
The authors have no proprietary interest in any materials or methods described within this article.
Accepted June 19, 2012