Microbial Analysis of Donor Corneoscleral Rims and Storage Media

Tsui, Edmund; Luong, Preston M.; Fogel, Jessa; Fogel, Erin; Zegans, Michael E.

doi:10.1080/09273948.2018.1459734

Cited by 7 publications

(4 citation statements)

References 9 publications

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“…Previous studies investigating positive donor rim fungal culture rates in storage media without amphotericin B have found the positivity rate to be relatively low, from 1.13% to 5.95%. [ 6 11 12 13 ] Our study is in agreement with these findings, with a donor rim fungal culture positivity rate of 2.9% in cases without amphotericin B supplementation in Optisol. In this study, in cases with amphotericin B added to Optisol, the positive donor rim fungal culture rate decreased to 1.7%; however, this change was not statistically significant ( P = 0.24).…”

Section: Discussionsupporting

confidence: 90%

“…In the present study, the incidence of fungal infection postkeratoplasty in cases without amphotericin B supplementation was extremely low, at 0.35% (3/853), similar to previous studies. [ 6 11 12 13 ] The incidence was 0.25% (1/393) in cases with amphotericin B supplementation to the preservation media, although the sample size was too small to determine its significance. Similar to studies in endophthalmitis, clinical infection rates at a single center are low; therefore, limited conclusions can be drawn from a study of this design.…”

Section: Discussionmentioning

confidence: 98%

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The impact of amphotericin B-fortified preservation media on donor rim cultures and posttransplant infection

Farid

Hussey

Sheils

et al. 2022

Indian J Ophthalmol

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Purpose: To determine the impact of amphotericin B supplementation to donor cornea preservation solutions on the rates of positive donor rim fungal cultures and postkeratoplasty fungal infections. Methods: This was a retrospective analysis of cases undergoing corneal transplantations at a single tertiary referral center from 2016 to 2021. Patients undergoing corneal transplantations with and without amphotericin B supplementation to the storage media were reviewed for donor rim culture results and postoperative infection. The primary outcome measures were positive donor rim fungal culture results and postkeratoplasty fungal infection. Results: A total of 1238 corneal transplants were analyzed. Of these, 849 were stored in preservation solution without amphotericin B, while 389 had amphotericin B included. There was a lower incidence of positive donor rim fungal cultures in cases with amphotericin B supplementation (1.8%) compared to the cases without amphotericin B (2.9%), although this difference was not statistically significant ( P = 0.24). Of the 389 cases with amphotericin B supplementation, one (0.25%) went on to develop clinically significant infection, while three of 849 (0.35%) cases without amphotericin B developed infection. The sample size was too small to determine the effect of amphotericin B on the incidence of postkeratoplasty fungal infection. Conclusion: The addition of amphotericin B to donor cornea preservation solution resulted in a downward trend of positive donor rim fungal cultures and postkeratoplasty fungal infections, although these differences did not reach statistical significance. Further studies with larger sample sizes are necessary to appropriately determine the impact of amphotericin B supplementation in the storage solution on positive donor rims and postkeratoplasty fungal infections.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 98%

The impact of amphotericin B-fortified preservation media on donor rim cultures and posttransplant infection

Farid

Hussey

Sheils

et al. 2022

Indian J Ophthalmol

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“…Over the last few years, an increase in fungal infective keratitis post-keratoplasty has been documented according to an EBAA medical report and many other publications [ 8 - 10 ]. The most common isolated fungus was Candida spp, while endothelial keratoplasty has demonstrated a higher affinity to acquire the infection than other forms of keratoplasty.…”

Section: Discussionmentioning

confidence: 99%

“…The most common isolated fungus was Candida spp, while endothelial keratoplasty has demonstrated a higher affinity to acquire the infection than other forms of keratoplasty. The reasons why fungal infective keratitis surpasses those of bacterial infective keratitis can be attributed to the lack of antifungal agents in Optisol-GS media, the use of broad-spectrum antibiotics postoperatively, and an increased warming time used in endothelial keratoplasty preparation [ 10 ]. However, in Europe where corneas are preserved in OC and supplemented with amphotericin B, the rate of positive fungal corneal rim cultures and post-keratoplasty fungal infections is less [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Incidence and Outcomes of Transplant of Infected Donor Corneal Tissues in a Tertiary Hospital in Saudi Arabia

Almulhim¹,

Alnaim²,

Abdulrazek³

et al. 2022

Cureus

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Purpose: The aim of this study is to assess donor rim culture results and predict ocular infections after corneal transplantation to determine the relationship between positive corneoscleral rim cultures and post-keratoplasty infection. Design: This is a retrospective study. Methods: The microbiology results of positive donor rim culture and clinical outcomes of all contaminated grafts at Dhahran Eye Specialist Hospital (DESH) in the Eastern Region of Saudi Arabia between October 2016 and February 2020 were reviewed. Results: A total of 684 corneal transplantation procedures were performed at DESH during this period. Routine donor rim cultures were done for all cases with six positive cases (0.88%). There were five positive fungal donor rim cultures (0.73%), and one corneal rim was positive for both bacterial and fungal cultures (0.15%). Among these six patients, two patients (33.33%) who received graft positive with candida developed an infection. Both cases required further interventions but were unsuccessful and eventually ended up with re-grafting. Conclusion: In the sample collected, positive fungal contamination was more frequent than bacterial contamination, and the incidence of bacterial infection is relatively low compared to that of fungal infection due to contaminated grafts. Despite the limitations of our study, we support routine corneoscleral rim culture and to start prophylactic antifungal treatment in response to positive donor fungal rim culture.

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Microorganism detection and contamination rate of donor eyes in Japan

et al. 2020

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Microbial Analysis of Donor Corneoscleral Rims and Storage Media

Abstract: Given the increasing rates of postkeratoplasty fungal infections, the identification of positive fungal cultures from donor rims and storage media warrants further evaluation of adding antifungals to storage media.

Cited by 7 publications

References 9 publications

The impact of amphotericin B-fortified preservation media on donor rim cultures and posttransplant infection

The impact of amphotericin B-fortified preservation media on donor rim cultures and posttransplant infection

Incidence and Outcomes of Transplant of Infected Donor Corneal Tissues in a Tertiary Hospital in Saudi Arabia

Microorganism detection and contamination rate of donor eyes in Japan

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