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Impact of Eye Bank Lamellar Tissue Cutting for Endothelial Keratoplasty on Bacterial and Fungal Corneoscleral Donor Rim Cultures After Corneal Transplantation

Rauen, Matthew P. MD*; Goins, Kenneth M. MD*,†; Sutphin, John E. MD; Kitzmann, Anna S. MD*; Schmidt, Gregory A. BS, CEBT; Wagoner, Michael D. MD, PhD*,†

doi: 10.1097/ICO.0b013e31823cbee3
Clinical Science

Purpose: To determine if the lamellar cut of donor tissue for endothelial keratoplasty (EK) by an eye bank facility is associated with a change in the prevalence of positive bacterial or fungal donor rim cultures after corneal transplantation.

Methods: A retrospective review was conducted of bacterial and fungal cultures of donor rims used for corneal transplantation at a tertiary eye care center from January 1, 2003, to December 31, 2008, with tissue provided by a single eye bank. The cases were divided into 2 groups. Group 1 (“no-cut”) included keratoplasty procedures in which a lamellar cut was not performed. Group 2 (“precut”) included EK procedures in which a 4-hour period of prewarming of tissue followed by a lamellar cut was performed in the eye bank before tissue delivery to the operating surgeon.

Results: There were 351 donor rim cultures in group 1 and 278 in group 2. Bacterial cultures were positive in 30 donor rims (8.5%) in group 1 and 13 (4.7%) in group 2 (P = 0.058). Positive bacterial cultures were not associated with any postoperative infections. Fungal cultures were positive in 8 donor rims (2.3%) in group 1 and 7 (2.5%) in group 2 (P = 1.0). Positive fungal cultures were associated with 2 cases (13.3%) of postoperative fungal infections.

Conclusions: Corneal donor tissue can be precut for EK by trained eye bank personnel without an increased risk of bacterial or fungal contamination.

*Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, IA

Iowa Lions Eye Bank, Iowa City, IA

Department of Ophthalmology, University of Kansas Medical Center, Kansas City, KS

Reprints: Michael D. Wagoner, Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, Pomerantz Family Pavilion, 200 Hawkins Drive, Iowa City, IA 52242-1091 (e-mail: michael-wagoner@uiowa.edu).

The authors state that they have no financial or conflicts of interest to disclose.

Received July 4, 2011

Accepted September 27, 2011

© 2012 Lippincott Williams & Wilkins, Inc.