Comparison of in situ Corneoscleral Disc Excision versus Whole Globe Enucleation in Cornea Donors Regarding Microbial Contamination in Organ Culture Medium – a Prospective Monocentric Study over 9 Years

Abstract

Background: Corneas needed for keratoplasty can be harvested using two techniques: whole globe enucleation and in situ excision of the corneoscleral disc. This study evaluates the rate of microbial contamination of the donor cornea organ culture medium according to the method of retrieval. Methods: All donor corneas of our cornea bank received between January 1, 2001 and December 31, 2009 put into organ culture and microbiologically tested were prospectively analyzed for microbial contamination of the organ culture medium. Results: 2,805 donor corneas could be included in this study in total. 975 of them were retrieved by whole globe enucleation (group 1) and 1,830 by in situ corneoscleral disc excision (group 2). 15 corneas of group 1 (1.5%) and 46 corneas of group 2 (2.5%) showed a contamination of the organ culture medium. The difference was shown not to be statistically significant (p = 0.082). Conclusion: The rate of microbial contamination in organ-cultured donor corneas does not seem to be dependent on the method of their retrieval.

Knowledge and attitudes toward corneal donation among Singaporean youth: a cross-sectional study

“…Under MTERA, the pledger can donate a whole eye for therapy and research but there has been very few cases of such request [ 27 ]. In terms of practice, cornea in situ recovery is well accepted and the preferred mode of cornea retrieval in the eye banking community [ 32 – 34 ]. Thus in Singapore, donated corneas are mainly recovered using in situ corneoscleral disc excision.…”

The influence of donor factors on corneal organ culture contamination

“…; Schroeter et al. ; Linke et al. ) have been analysed with respect to their impact on donor cornea contaminations.…”

Factors influencing the contamination rates of the conjunctival swabs and organ culture media of human donor eyes

“…The transplantation of contaminated corneal tissue may lead to postoperative endophthalmitis, which represents one of the most serious post-keratoplasty complications, and it may have devastating consequences for a patient's vision. [ 4 – 9 ] Contamination rates of 0.53% to 15.7% have been reported [ 10 – 21 ] ; therefore, extensive decontamination procedures have been advocated to minimize the risk of donor cornea contamination. Until January 2018, the German guidelines on the collection and processing of donor corneas have required 2 microbiological examinations of the donor's cornea using conjunctival swabs after disinfection and before the corneal excision or enucleation.…”