Purpose: To evaluate the prevalence of positive microbiology results (culture and/or Gram stain) in donor cornea tissue with newer transplant methods and to assess if the results subsequently correlate with higher incidence of clinical infection.
Methods: A retrospective review of the microbiology records of 569 consecutive corneal transplants from July 2006 through July 2010 was performed to evaluate positive microbiology results in routine evaluation of cornea donor tissue.
Results: Microbiologic results were available for 544 of 569 transplants. The remaining 25 cases did not have specimens submitted for microbiologic analysis. In cases with results available, 46 (8.5%) positive reports occurred. In 10 of the 46 cases, Gram stain results were positive with subsequent negative cultures. Analysis revealed that the prevalence of positive results was 6 in 137 (4.4%), 14 in 127 (11.0%), and 26 in 271 (9.6%) for femtosecond laser–enabled keratoplasty, Descemet stripping automated endothelial keratoplasty, and conventional penetrating keratoplasty, respectively; 9 femtosecond deep anterior lamellar keratoplasty had no positive results. There was no significant relationship between the types of transplant procedures and the occurrence of positive microbiologic results (P = 0.08). The overall incidence of clinical infection was found to be 0.4% (2 of 569); however, only 1 case (1 of 569 or 0.2%), which was a Candida albicans infection after Descemet stripping automated endothelial keratoplasty, was attributable to the donor. Of 25 cases in which microbiology studies were not performed, none developed a clinical infection.
Conclusions: Prevalence of positive microbiologic results and subsequent infections do not appear to be increased with the method of donor handling used for newer techniques for keratoplasty.